»        ^ 


OF   THE 


^liiiDerstto   of  Califoitiiia. 


Name  of  Book  and  Volume, 


Division 

Range 

Shelf.. 

Received. 187 


A — 


!  University  of  California. 

! 

I  THE  MEDICAL  LIBRARY 

I  \  .  ^  .    IN  )  r  i{  ci  1:  A  1'  I  >.    M  .  I ) . 

j  or  San   Frvncisco. 

i 

j  PEESENTED  BY  MKS.  AND  MISS  FOURGEAUD. 

i  I  r.iiin   \it\.  is;.-,. 


—^ 


SELECTIONS 


FROM 


FAVORITE  PRESCEIPTIONS 


OP 


LIVING  AlEEICAN  PRACTITIONERS. 


BY   HORACE  CREEN,  M.D.,  LL.D  , 

PBBSIDENT  OF  THB    FACULTY,  ASD    EMEK1TU3   PROFESSOE  OF  THE  THEORY    AND   PRACTICB  OF 

MEDICINE    IS   THE    SEW   YORK   MEDICAL    COLLEGE  ;     CORBBSPONDINO    FELLOW   Off 

THE   LONDON   MEDICAL  SOCIETY;   MEMBER  OF  THB  AMERICAN 

MEDICAL  ASSOCIATION,  ETC. 


NEW   YORK: 
J.  WILEY,  56  WALKER  STREET. 

1860. 


VI0U)9& 

UBRiVGLX 


Ektbbkc  aeeordinj  lo  Act  of  CongreM,  in  Uie  yMtf  185?,  by 

HORACE    GREEN, 

to  tk*  Clerk'i  C-ffice  01  the  Di»tricl  Court  of  the  United  SUtM,  fw  th*  Saotheni  Dirtriel  rf  »»w  To*. 


W.  H.  TiUBOK,  Stereotype r, 

Rear  of  43  &  46  Ceotre  St.,  N.  T. 


CONTENTS. 


CHAPTER  L 

NAKCOTICS  AJTD  SEOATIYXS. 

HydrocyaiKi  Acid  with  Morphia,  etc., 1 

"             "        "    Antimony,  etc., 2 

"             "        "    Ipecacuanha, S 

"             "        "    Liquor  Potassae, 4 

"             "        "    Belladonna, 5 

Cyanide  of  Potassium, 6 

Hyoscyamus  with  Morphia,  etc., 7 

"             "    Valerianate  of  Iron, 8 

"             "               "            Zmc, 9 

Belladonna      "    Quinine,  etc., 10 

"             "    Zinc  and  Ipecacuanha, 11 

Hyoscyamus     "    Nitrate  of  Silver, 12 

Conium  with  Calomel,  etc., .13 

Belladonna  with  Quinine, I4 

Opium  with  Capsicum,  Mther,  etc., I5 

Hyoscyamus  with  Bismuth,  etc, 16 

Conium  with  Nitrate  of  Silver,  etc., 17 

LupuUne  "          "             <i        " jg 

Hyoscyamus  with  Morphia,  etc., 19 

Quinine           "          «4                         2o 

Muriate  of  Ammonia  with  Opium,  etc., 21 

Assafoetida  with  Morphia, 22 

CHAPTER  II. 

TONICS  AND   STIMULANTS. 

Carb.  Iron  with  Extract  Conium,  etc., 23 

"        "      "         "       Taraxicum, 24 

Citrate  of  Iron  with  Syr.  Aurantia,             25 

Phosphate  of  Iron  with  Qoinine,        ••.....  2a 

8 


IV 


CONTENTS. 


Syr.  Iodide  of  Iron  with  Tr.  Aconitine, 
Extract  Hyoscyamus  with  Conium,  etc.,     . 
Sulphate  of  Iron  with  Iodide  of  Potassium, 
Fowler's  Solution  with  Tr.  Cinchonse, 

"  "  "     Quinine, 

Arsenic  with  Quinine,        .... 
Phosphate  of  Manganese  with  Tr.  Cinchonas, 

"  "  "     Phos.  Iron, 

Malate  "  "     Cinchona, 

Iodide  "  "    Tr.  Cardamom., 

Carb.  "  "     Carb.  of  Iron, 

'«  "  "    Tr.  Columbo, 

"  "  "    lod.  Potass., 

Fusil  Oil  or  Grain  Oil,  .... 

Extract  of  Nux  Vomica  with  Tr.  Cardamom., 

"  "  "  "    Opium, 

Nux  Vomica  with  Oxide  of  Silver, 
Bismuth  with  Columbo,      .... 
Solution  of  Strychnia,  etc., 

"  "  with  Cardamom.,     . 

"  "  "    Quinine,  etc., 

"  "  "    Morphia, 

Quinine  with  Piperine 

Strychnine, 

"  with  Lobelia, 

Corrosive  Sublimate  with  Nux  Vom.,  etc.. 
Extract  Aconite  with  Arsenic,  . 

"      Belladonna  with  Iron,  etc.,   . 
Potass.  Hydrocyanic  Acid,  etc.. 


27 
28 
29 
30 
31 
32 
33 
34 
35 
36 
37 
38 
39 
40 
41 
42 
43 
44 
45 
46 
47 
48 
49 
50 
51 
52 
53 
54 
65 


CHAPTER   III. 


EXCITANTS    AND   ALTERATIVES. 


Iodide  of  Potass.,  Tr.  Rhubarb,  etc., 
Decoc.  Senega  and  Potass., 
Iodine  and  Iodide  of  Potass.,     . 
led.  Potass.,  Senega  and  Lobelia, 
Iodide  of  Mercury,  lod.  Potass., 
Iodide  Potass.,  Tr.  Gentian,  etc.. 
Extract  Conium,  lod.  Potass.,  etc., 
Donovan's  Solution,  etc.,   . 
Iodide  Potass,  and  Antimony,    . 
"  "         "     IpecacuanJ.a, 

"  "        "     Hydrocyanic  Acid, 

"  "         "     Iodine,  etc., 


56 

57 
58 
59 
60 
61 
62 
63 
64 
65 
66 
67 


CONTE 

NTS. 

V 

Iodine  Liquor  Potassae,  etc., 68 

Iodide  of  Potass,  and  Tr.  Hyoscyamu3, 

69 

Syrup  Iodide  of  Iron,  Potass.,  etc.,    . 

70 

Arsenic  with  Extract  Conium,    . 

11 

"         "     Liq.  lod.  Potass., 

VI 

Iodide  of  Lead  Ointment,  . 

73 

Manganese  with  lod.  Potass.,     . 

74 

Corrosive  Sublimate  with  Extract  Conium, 

75 

"                 "           "     Opium, 

76 

"                 "         in  pills, 

77 

"                 "        with  Gentian.,    . 

78 

Calomel  with  Sugar,  .... 

79 

"          "     Opium  and  Ipecac, 

80 

Podophyllum  with  Aloes,  . 

81 

"              "     Calomel, 

82 

"              "     Gentian,  etc.. 

83 

Podophyilin  with  Sugar,     . 

84 

Sanguinaria  with  Tinct.  Aloes,  . 

85 

"              "     Ipecacuanha,  . 

86 

"              '•     Tinct.  Opium, 

.       87 

"              "     Morphia,  Antin^ony,  etc 

> 

.       88 

"              "     Digitalis,         "             " 

.       89 

"              "     Rhubarb,  etc.. 

.       90 

Actea  Racemosa  with  Potassa,  . 

.       91 

"             "             "     Sanguinaria,    . 

.       92 

"             "          Infusion  of. 

.        93 

*'             "          with  Myrrh,  etc.,     . 

94 

Veratmm  with  Squills, 

.       95 

(i          It          (( 

.       96 

CHAPTER 

IV. 

CATHARTICS    AND   LAXATIVES. 


Aloes  with  Guiac.  and  Gamboge, 

"       "     Calomel,  Jalap,  etc., 

"        "     Rhubarb,  etc., 

"       "     Aromatics, 

"        "     Ipecacuanha,  etc.,    . 

"        "     Mastic,  etc.,     . 

"        "     Antimony,  Calomel,  etc.. 
Extract  Colocynth,  Calomel,  etc.. 
Blue  Mass  with  Aloes,  etc. 
Aloes  with  Carb.  Soda,  etc.,      . 


97 

98 
99 
100 
101 
102 
103 
104 
105 
106 


VI 


CONTENTS. 


Aloes  with  Syrup  Rhubarb, 
Extract  Taraxicum  with  Manna, 

"  "  "    Aloes,  etc., 

Magnesia  with  Rhubarb,  etc.,    . 
Sulphate  of  Magnesia,  etc.. 
Nitrate  Potass,  with  Castor  Oil, 
Infusion  of  Senna,  Rhubarb,  etc., 
Extract  Hyoscyamus,  Blue  Mass,  etc. 
"       Conium  with  Calomel, 
"       Hyos.  -with  Sulph.  of  Iron, 
Aloes,  Rhubarb,  Jalap,  etc., 

"       Belladonna  and  Rhubarb, 
Sulphate  Magnesia  with  Elix.  Vit., 


lOY 

108 
109 
110 
111 
112 
113 
114 
115 
116 
117 
118 
119 


CHAPTER  V. 


KUETICS    AND    EXPECTOBAKTS. 


Antimony  and  Ipecacuanha, 120 

"  "  etc.; 121 

Sulphate  of  Zinc  with  Ipecac, 122 

Turpeth  Mineral,  etc., 123 

Sulphate  of  Copper  and  Sulphate  of  Zinc, 124 

Ipecacuanha,  etc, 125 

Ipecacuanha  with  Mint  water, 126 

Sanguinaria  Emetic, 127 

Lobelia  with  Squills, 128 

Senega  with  Iodide  of  Potassa, 129 

Ammoniacal  mixture  with  Squills, 130 

Syr.  Squills  with  Bloodroot, 131 

Potassa  with  Musk,  etc., 182 

Senega  with  Morphia,  etc., 133 

*'         "     Ipecacuanha, 134 

"        "    Squills,  Opium,  etc., 185 

"        "    Antimony,  Ipecac,  etc., 136 

Canada  Balsam  with  Potass,,  etc., 137 

«'  "  "     Cyanide  of  Potass., 138 

Copaiba     "       Opium,  Ipecac,  etc., 139 

Cyanide  of  Potass,  with  Morphia,  etc., 140 

Wine  of  Ipecac  with  Tolu., 141 

Glycerine  with  Iodide  of  Iron, 142 

"  "    Hypophosph.  Soda, 143 

Sulph.  Magnesia  with  Elix.  Vitriol,    .......  144 


CONTENTS. 


Vll 


CHAPTER   VI. 


ASTRINQENTS. 


Opium  with  Camphor  and  Soap, 145 

"        "    Acetate  of  Lead,  etc., 146 

"         "    Nitrate  of  Silver, 147 

Acetate  of  Lead  with  Digitalis,  etc., 148 

"  "         "     Tiuct.  Opium, 149 

"  "        "    CiuQamon  water, 150 

Catechu  with  Opium,  etc., 151 

Oil  of  Turpentine  with  Opium,  etc., 152 

Nitrate  of  Silver       "         "  153 

Cascarilla  with  Nux  Vomica,  etc.,      .......  154 

Sulphate  of  Zinc  with  Opium,  etc., 155 

"  Copper  with  Opium,  etc., 156 

Tannin  with  Extract  Gentian, 157 

"  "     Opium,  etc., 158 

"         "    UvaUrsi, 159 

Gallic  Acid  with  Acacia, 160 

"        "      "     Tolu.,  etc., 161 

Camphor  with  Capsicum,    ...*..*••  163 


CHAPTER   VII. 


DIAPHORETICS. 


Spts.  of  Mindereri  with  Antimony,  etc., 
"  "  "     Camphor,  etc., 

Antimonial  Wine,  with  Nitrate  of  Potass., 
Sulph.  Magnesia  with  Antimony,  etc., 
James's  Powder  with  Calomel,  etc.,   . 
Nitrate  of  Potass,  with  Opium,  . 
Dover's  Powder  with  Calomel,  etc.,    . 
Spts.  Mindereri  with  Spts.  Nitre,  etc., 
Antimony  with  Cinnamon  Water, 
Ipecacuanha  with  Snakeroot,     . 
Carb.  Potass,  with  Paregoric,    . 
Carb.  Soda  with  Spirits  of  Nitre, 
Nitrate  of  Potass,  with  Antimony,     . 
Carb.  Ammonia  with  Paregoric,  etc., 


163 
164 
166 

166 
167 
168 
169 
170 
171 
172 
173 
174 
17.') 
176 


Vlll 


CONTENTS. 


CHAPTER    VIII. 


Juniper  with  Spirits  of  Nitre, 
Digitalis  with  Corrosive  Sub.,  etc., 
Camphor  with  ^ther,  Digitalis,  etc., 
Colchicum  with  infusion  of  Juniper, 

"  "    Iodide  of  Potass.,  etc 

Ealterium  with  Digitalis,  etc.,    . 
Tincture  Cantharides  with  Nitre,  etc. 

"        Cinchona  with  Cantharides,  etc.. 
Juniper  with  Nitrate  of  Potass., 


Ill 
178 
179 
180 
181 
182 
183 
184 
185 


CHAPTER    IX. 


ANTISPASMODICS. 


Assafoetida  with  Morphia, 186 

"              "     Camphor  and  Morphia, 187 

"              "            "          "    Musk, 188 

Musk  with  JEther  and  Opium, 189 

Castor  with  Assafoetida,  etc., 190 

"          "     Morphia,  Valeriana,  etc., 191 

Valeriana  with  Magnesia,  Opium,  etc., 192 

Spirits  of  Lavender,  jEther,  etc., 193 

Valerianate  of  Zinc  with  Tr.  Valeriana, 1 94 

Hyoscyamus  with  Bismuth,  etc., 195 

Valerianate  of  Ammonia,  etc., .  196 


CHAPTER    X. 


ANTHELMINTICS. 


Spigelia,  Infusion  of, 197 

"         with  Tin, 198 

"  "    Senna,  etc., 199 

"  «'     Potass.,  Jalap,  etc., 200 

dale  Fern, 201 

"       "      in  Infusion, 202 

Kousso  in  Infusion, •  203 

Oil  Turpentine  with  Barley  decoction, 204 

Oil  of  Worm  Seed, 205 

Biniodide  of  Mercury, 206 


CONTENTS. 


IX 


CHAPIER    XI. 


EMMENAQOGUES. 


Sulphate  of  Iron  with  Iodine,     . 
Carb.  of  Iron  with  Columba,  etc., 
Citrate  of  Iron  with  Syr.  Orange  peel. 
Aloes  with  Sulph.  of  Iron, 
Iodide  of  Potass,  with  Colchicum, 
Aloes  with  Sulphate  of  Iron,  etc., 

"        "    Borax,  Castor,  etc., 
Colchionm  with  Strammonium,  etc., 
Iodide  Potass,  with  Proto-Iod., 
Guiacum  with  Soda,  etc.,    . 


207 
208 
209 
210 
211 
212 
213 
214 
215 
216 


CHAPTER   XII. 


GARGLES    AND    LOTIONS. 


Nitrate  Silver  with  Rose  Water, 
Nitrate  of  Potass,  with  Honey,    . 
Creosote  with  Tinct.  Myrrh,  etc., 

"  "        "      Capsicum,  etc , 

Decoction  Barley  with  Myrrh,  etc.. 
Chloride  Soda  with  Honey  of  Roses, 
Corrosive  Sublimate  with  Spirits  Wine,  etc. 
Infusion  of  Roses  with  Tr.  Myrrh, 
Tinct.  Capsicum  with  Alum, 
Docoction  of  Oak  with  Alum, 
Alum  with  Zinc, 
Chloride  Lime  with  Opium, 


211 
218 
219 
220 
221 
222 
223 
224 
225 
226 
227 
228 


CHAPTER  Xm. 


ANTACIDS   AND   ANTILITHICS. 


Carb.  of  Soda  with  Aromat.  Sp.  of  Ammon., 
Soda  with  dilute  Sulph.  Acid,  etc.. 
Magnesia  with  Lime  water,  etc., 

"         "    Sulph.  of  Magnea.,  etc., 
Chalk  mixture, 
Carminative  of  Dr.  Dewees, 
Prepared  Chalk  with  Acacia,  etc.. 
Aquae  Ammon.  with  Infus.  Gentian., 
Liquor  of  Potassa  with  Tr.  of  Hops, 
Iodide  of  Potass,  with  Liquor.  Potass., 
Potassio-Tartrate  of  Soda,  Colchicum,  etc., 


229 
230 
231 
232 
233 
234 
235 
236 
287 
238 
239 


CONTENTS. 


CHAPTER    XIV. 


DKBITATITES  OB  COUNTER-IRRITANTS,   OINTMENTS,   ETC. 


Oil  of  Origanum,  Ammonia,  etc., 
"  "  Tinct.  Opium,  etc.,  . 

"  "  Camphor,  Chloroform,  etc., 

Tinct.  of  Arnica,  Ammonia,  etc., 

"  Aconite,  Chloroform,  etc.,    . 

Soap  Liniment  and        " 
Camphor,  Chloroform,  Turpentine,  etc., 
Ointment,  Antimony,  Camphor,  etc., 

"  "  and  Ipecac, 

Solution  "  and  Potassium, 

Ointment,         "  Croton  Oil,  etc, 

Soap  Liniment  and  "        " 

Sulph.  iEther     « 
Ointment,  Potassium,  etc.,  . 

"  "         and  Iodine, 

"        Strammonium  and  Lead,     . 

"  "  "    Galls,     . 

"        Galls,  Opium,  etc.. 
Iodine  Ointment,         .... 
Veratrine  Ointment,    .... 

"        and  Kose  Ointment,    . 
Oil  of  Tobacco  and  Precipitate  Ointment, 
Ointment,  Red  Precipitate, 
Lotion  for  Ophthalmia,        .        .        . 
Toxicological  Table, 


240 
241 
242 
243 
244 
245 
246 
24Y 
248 
249 
250 
251 
252 
263 
254 
255 
256 
257 
258 
259 
260 
261 
262 
263 
203 


Index, 


211 


PREFACE   TO   THE   SECOND   EDITION. 


In  publishing  the  first  edition  of  this  work,  the  author 
was  influenced,  as  he  stated  in  the  Introduction,  bj  the 
many  requests  which  he  had  received  from  judicious 
physicians,  urging  him  to  collect  and  publish  these  Pre- 
scriptions (some  of  which  had  already  appeared  in  the 
"  American  Medical  Monthly " )  in  a  book  form.  The 
call  for  a  new  edition  of  the  work,  in  so  brief  a  period 
after  its  first  publication,  exhibits  satisfactory  evidence 
that  in  this  opinion  his  professional  friends  adjudged  cor- 
rectly ;  and,  moreover,  it  has  afforded  the  highest  grati- 
fication to  the  author. 

To  this  edition  has  been  added  a  carefully  prepared 
ToxicoLOGioAL  Table,  in  which  are  exhibited  the  symp- 
toms of  poisoning,  the  antidotes  for  each  poison,  and 
the  tests  proper  for  their  detection.  Christison's  divi- 
sion of  poisons  into  irritants,  narcotics,  and  narcotico- 
acrids,  has  been  adopted  in  this  Table.  The  value  of 
the  work  to  the  practitioner  will  be  enhanced  by  this 
addition. 

In  prei)aring  the  present  volume  for  the  press,  the 
author  has  endeavored  to  correct  the  errors  that  aj^peared 
in  the  first  edition  ;    and  he  sincerely  hopes  that  the 


Xii"  PREFACE    TO    THE    SECOND   EDITION. 

work,  in  its  present  form,  will  be  successful  in  accom- 
plishing what  he  originally  intended  it  should — ^namely, 
that  it  may  afford  to  the  experienced  physician  valuable 
suggestions ;  whilst  to  the  young  practitioner  it  may 
prove  to  be  a  helper  in  the  discharge  of  his  responsible 
duties. 

H.  G. 


INTRODUCTION. 


A  PART  of  the  Prescriptions  contained  in  this  volume 
have  already  appeared  in  the  Amkricaj^  Medical 
Monthly. 

The  following  are  the  circumstances  under  which  they 
were  originally  collected : 

For  many  years  past,  the  Author's  Rooms,  for  the 
treatment  of  patients,  have  been  visited  daily  by  medical 
men  from  all  parts  of  the  Union,  who  have  called  on 
him,  either  from  curiosity,  or  from  a  desire  to  observe 
every  improvement  in  practical  medicine.  It  will  be 
within  the  truth  to  state  that  the  numbers  of  those  by 
whom  he  has  been  in  this  way  honored,  have  equalled 
nearly  one  thousand  annually. 

Ever  ready  to  communicate  to  the  profession  any,  and 
whatever,  practical  knowledge  might  be  in  his  pos- 
session, the  author  has  never  hesitated  to  ask  of  others 
such  useful  information  as  they  might  have  derived 
fi'om  experience  and  observation.  Acting  on  this  princi- 
ple, he  has  accustomed  himself  for  many  years,  when 
visited  by  experienced,  practical  physicians,  to  request 
of  them  copies  of  some  of  their  favorite  prescriptions — 
those  prescriptions,  from  the  employment  of  which  they 
have  derived  the  greatest  advantage  in  the  treatment  of 
disease.  In  this  way  he  has  collected  together  two  large 
manuscript  volumes  of  medical  formulae,  obtained  from 

practitioners  who  have  come  from  every  section  of  the 

11 


Xii  INTRODUCTION. 

Union — many  of  them  being  the  contributions  of  some 
of  the  most  distinguished  American  physicians  and  sur- 
geons of  the  present  time.  These  therapeutic  excerpts, 
which  have  come  to  the  author  through  individual  con- 
tributions, and  are  the  collections  of  much  labor,  he  pro- 
poses to  give  back  to  the  whole  faculty,  as  the  choice 
formulae  of  many  of  the  profession  of  our  country. 

He  has  been  induced  to  publish  this  volume  of  "  Fa- 
vorite Prescriptions  of  Living  American  Practitioners," 
by  several  considerations. 

A  part  of  the  formulae  having  appeared  from  time  to 
time  in  different  numbers  of  the  Medical  Monthly  during 
the  last  two  or  three  years,  they  have  been  extensively 
copied,  not  only  into  the  medical  journals  of  this  country 
and  of  the  Canadas,  but,  also,  into  many  of  the  European 
journals,  which  clearly  shows  that  some  degree  of  esti- 
mation was  placed  upon  the  value  of  these  preferred 
formulae  of  American  practitioners.  But  a  stronger 
inducement  than  the  above,  has  been  presented  to  the 
author,  in  the  many  requests  that  have  come  to  him  from 
eminent  physicians  In  different  parts  of  the  Union — ■ 
physicians,  upon  whose  judgment  he  feels  disposed  to 
rely — urging  him  to  collect  and  publish  these  Prescrip- 
tions in  a  Book  form. 

Moreover,  since  the  intention  of  the  publication  of  this 
volume  was  known,  a  large  number  of  additional  excel- 
lent formulae,  which  cannot  fail  to  enhance  the  value  of 
the  collection,  have  been  furnished  for  the  work,  by  dif- 
ferent medical  men  of  skill  and  experience. 

"With  the  scientific  physician  it  is  a  matter  of  regret  that, 
m  our  present  state  of  medical  knowledge,  we  cannot 
claim  for  the  principles  of  Therapeutics  that  they  are 
fully  established  on  rational  grounds.  Until  the  relations 
which  exist  between  the  pathological  condition  of  inter- 
nal diseased  organisms,  and  the  action  of  therapeutic 
agents,  are  better  understood,  our  knowledge  of  the  ulti- 
mate influence  of  medicinal  substances  upon  these  mor- 


INTRODUCTION.  XllI 

bid  conditions  must,  necessarily,  be  imperfect,  and  our 
system  of  Therapeutics  be  considered  rather  empirical 
than  rational.  We  know  from  experience — and  expe- 
rience only — that  certain  remedies  are  valuable  in  the 
treatment  of  certain  diseases ;  but,  even  this  knowledge 
is  limited ;  and  hence  the  importance  of  extending  its 
boundaries  by  collecting  further  materials  from  the  prac- 
tical observations  of  the  experienced  in  our  profes- 
sion. 

The  publication  of  these  tried  formulae,  with  appended 
observations — which  are  the  contributions  of  many  of 
the  distinguished  practitioners  of  our  country — will  not 
fail,  it  is  believed,  to  add  to  our  stock  of  knowledge  in 
both  Rational  Therapeutics,  and  Practical  Medicine. 
To  the  young  and  inexperienced  practitioner,  the  work 
will  afford  material  aid.  But,  in  placing  in  the  hands  of 
this  class  of  the  profession  so  many  powerful  "  instru- 
ments for  combating  the  aggressions  of  disease,"  we 
must  not  omit  to  caution  the  practitioner  against  a  too 
energetic  adoption  of  active  therapeutic  agents  in  resisting 
diseased  action.  There  is  in  every  living  body  a  vital 
principle  whose  constant  tendency  is,  not  only  to  repel 
the  action  of  morbific  causes,  but  to  restore  that  body 
when  diseased,  to  its  original  normal  condition.  The 
scientific  and  experienced  physician  will  always  respect 
this  conservative  power  or  principle ;  and  in  each  in- 
stance of  disease,  will  seek  to  ascertain  how  far  the  case 
may  be  safely  intrusted  to  the  care  of  Nature,  and  to 
what  extent  the  intervention  of  Ai't  may  be  required. 
From  long  experience,  in  observing  the  practice  of  medi- 
cal men,  the  author  is  convinced  that,  as  good  judgment 
and  as  careful  discrimination  are  required,  in  the  prac- 
titioner, to  enable  him  to  decide  at  what  point,  and  how 
long,  to  withhold,  altogether,  the  administration  of  reme- 
dies, as  to  'know  when,  and  to  what  extent,  therapeutic 
measures  are  to  be  invoked,  in  the  management  of  dis- 
ease.    But  he  cannot  do  the  pr  >fession  a  better  service 


XIV  INTRODUCTION. 

than  to  embody  liere  the  experience  of  one  of  the 
most  eminent  and  judicious  living  practitioners  of  this 
country,  as  it  is  given,  in  his  own  words,  in  a  recent  com- 
munication to  the  Author. 

"  I  have  seen,  and  have  prescribed,"  writes  he,  "  and, 
in  some  instances,  with  apparent,  signal  advantage,  some 
of  the  '  Prescriptions  of  Distinguished  Living  American 
Physicians,'  which  have  appeared  from  time  to  time 
under  your  sanction,  in  the  American  Medical  Monthly^ 
and  I  rejoice  that  you  are  about  to  embody  and  publish 
them  in  a  book  form,  for  the  benefit,  and  at  the  call  of 

the  profession During  my  whole  medical 

life  (now  counting  forty  full  years  !)  I  have  always  been, 
and,  for  the  last  decennial  period,  have  almost  daily 
been  becoming  more  and  more  a  dear  lover  of  simplicity 
in  my  use  of  the  Materia  Medica,  especially  in  all  forms 
of  chronic  disease.  My  medical  armamentarium  com- 
prises but  a  very  small  number  of  the  articles  which  go 
to  swell  the  bulk  of  our  pharmacopoeias  and  Dispen- 
satories— ^my  distrust  of  these,  and  my  confidence  in  the 
old  fashioned  '  vis  medicatrix  naturae,"  have  been  for 
several  years  past  increasing  '  pari  passu.' 

"When  I  commenced  my  profession  (in  the  spring  of 
1818),  and  for  many  years  after,  my  reliance  on  medication 
was  most  unbounded  ;  that  there  were  known  means  for 
the  cure  of  every  disease,  and  that  any  fatal  event  within 
my  manor  would  be  justly  chargeable  to  me,  I  confi- 
dently believed.  I  gloried  in  the  reputation,  which  I  did 
not  fail  soon  to  acquire,  both  with  the  profession,  and  the 
little  public  (whose  misfortune  it  was  first  to  receive  the 
yet  unfledged  diplomora^X  as  their  future  medical  adviser), 
of  being  '  a  most  heroic  practitioner,'  not  in  the  way  of 
reproach,  indeed,  but  of  applause.  I  had  just  emerged 
from  the  '  Philadelphia  School,'  and  Dr.  Sangrado  him- 
self never  wielded  the  lancet  more  indiscriminately  than 
did  I,  having  just  returned  from  listening  to  the  lectures 
of  Dorsey,  Physick,  Chapman,  and  others,  who,  it  has 


INTRODUCTION.  XV 

often  seemed  to  me,  actually  thouglit,  that  there  was  no 
limit  to  the  supply  of  blood  in  the  human  body.  They 
had  taught,  and  I  had  received  the  dictum,  without  the 
slightest  grain  of  doubt,  that  all  disease  had  its  origin  in 
increased  vascular  energy  and  force,  for  which  the  only 
legitimate  remedy  was  primarily  venesection,  and  then 
its  congeners,  cathartics,  sudorifics,  emetics,  sialogogues, 
diuretics,  '  et  id  omne  genus,' — that  all  disease  was  an 
entity,  and  like  some  wild  beast,  was  to  be  hunted  with- 
out parley  or  delay ;  and,  with  all  the  energies  and 
means  at  command,  to  be  exterminated,  lest  his  ravages 
should  incontinently  raze  to  the  ground  the  citadel  of 
life.  And — oh,  the  delusion  ! — success  seemed,  not  only 
to  me,  but,  to  my  confiding  patrons,  to  be  the  reward  of 
this  mad  medical  philosophy.  But  a  change  soon  '  came 
over  the  spirit  of  my  dreamt  For  many  years  past,  a 
masterly  inactivity  has,  in  many  cases,  supplanted  this 
energetic  draught  upon  tissue,  organ  and  function.  I 
still  have  faith  in  the  efficacy  of  Opium,  Antimony,  Calo- 
mel, Elaterium,  '  Nitrate  of  Silver,'  but  action  waits  upon 
patient — -patient  Diagnosis ;  nor  is  one  of  those  potent 
life-preservers  permitted  to  make  its  irreparable  entrance 
into  the  inner  man,  until,  by  scrutinizing  observation 
assured  of  the  '  Nodus  vindice  dignus.'  '' 

Wlienever  simple  remedies  can  be  employed  with 
equal  efficiency,  such,  undoubtedly,  are  to  be  j^referred 
to  compound  medicines  in  the  treatment  of  disease.  It 
should  never  be  forgotten,  however,  that  "  it  sometimes 
happens  that  the  most  skillful  physician  is  he  who  pre- 
scribes nothing." 

On  this  great  question  in  Medicine — the  powers  of 
Nature  to  arrest  the  processes  of  disease— Sir  John 
Forbes  has  just  published  a  most  valuable  work,  and  the 
author  would  earnestly  recommend,  particularly  to  the 
younger  members  of  the  profession,  a  careful  perusal  of 
this  Essay,  on  "  Nature  and  Art  in  the  Cure  of  Disease." 

In  the  following  Prescriptions  several  ingredients  are 


XVI  INTRODUCTION. 

frequently  combined  in  one  formula.  In  some  instances 
this  is  done  in  order  to  obtain,  simultaneously,  the  effects 
of  two  or  more  remedies  ;  in  others,  to  increase  or  dimin- 
ish, as  the  case  may  require,  the  action  of  the  base,  or 
principal  remedy.  But  still  more  frequently  are  combi- 
nations effected  for  the  purpose  of  rendering  the  remedies 
indicated  as  agreeable  as  possible,  without,  in  any 
degree,  impairing  their  efficacy. 

Many  of  the  formulae,  as  here  presented — ^the  propor- 
tions of  their  combinations  varied  to  meet  particular 
cases — ^have  been  employed  by  the  author,  and  their 
value  tested  in  an  extensive  practice,  and  through  many 
years. 

For  obvious  reasons  the  various  formulae  have  been 
arranged  under  their  appropriate  heads. 

Horace  Geeen, 

New  York,  12  Clinton  Place, 
August,  1868. 


FAVORITE  PRESCRIPTIONS 


or 


Lwrna  mmicM  practitioners. 


CHAPTER  I. 

NARCOTICS   AND    SEDATIVES. 

The  narcotic  principle  in  medicine  differs  from 
that  of  the  sedative  in  this,  that  its  primary  action 
is  in  some  degree  stimulant,  whilst  the  sedative 
principle  tends  directly  to  depress  the  vital  powers 
without  inducing  any  previous  excitement.  The 
ultimate  action  of  both  narcotics  and  sedatives  is 
to  diminish  the  sensibility  of  the  nervous  system, 
thereby  allaying  pain  and  promoting  sleep. 

Among  the  direct  sedatives  Hydrocyanic  Acid  is 
one  of  the  most  prompt  and  efficient.  Adminis- 
ir  2 


18  NARCOTICS   AND    SEDATIVES. 

tered  in  appropriate  doses,  it  tends  directly  to 
lower  the  sensibility  of  the  nervous  system,  to 
diminish  the  frequency  of  the  pulse,  and  to  induce 
a  sensation  of  quiet  and  calmness  throughout  the 
whole  system.  Alone,  or  in  conjunction  with 
other  remedies,  Prussic  Acid  constitutes  one  of 
our  most  valuable  therapeutic  agents. 

The  following  combinations  with  this  remedy 
have  been  proved  to  be  of  great  service  in  the 
treatment  of  disease  : 

1. 

^  Acidi  Hydrocyanici,  Medicinalis,  gtt.  Ix. 

Morphise  Sulph gr.  iij. 

Tinct.  Sanguinariae, 

Yini  Ipecacuanhse,      .     .     .     .     aa  f.  S  ss. 

Syr.  Pruni  Yirginianse, 


f.  S  V. 
Vel  Misturae  Amygdalae, '     '     '      * 

Fiat  mistura  cujus  sumat  cochlearium  parvum 

bis  terve  in  die. 

We  have  found  the  above  a  most  valuable 
remedy  in  the  treatment  of  chronic  bronchial  dis- 
ease ;  in  allaying  the  cough  present  in  tubercu- 
losis, and  in  all  pulmonary  catarrhal  diseases, 
unattended  with  fever.  As  the  acid  is  apt  to 
float  on  the  top  of  the  liquid,  the  phial  should  be 
shaken  on  the  administration  of  each  dose. 


NARCOTICS   AND    SEDATIVES.  19 


^  Acidi  Hydrocyanici,  gtt.  xl. 
Vini  Antimonii,     .     f.  S  ss. 
Syrupi  Tolutan.,   .     f.  5  ss. 
Mucil.  Acaciae,      .     f-  S  ij. 
Fiat   mistura,  capiat   cochl.  parvum   ter   qua- 
terve  in  die. 

This  may  be  used  in  the  same  cases  as  the 
former,  when  the  cough  is  troublesome,  and  is 
attended  with  some  degree  of  fever. 

As  a  remedy  in  the  treatment  of  hooping-cough, 
Hydrocyanic  Acid  surpasses  in  efficiency  every 
other  known  general  remedy.  We  have  employed 
it  for  many  years  in  this  disease,  and  can  fully 
substantiate  the  declaration  of  Dr.  Hamilton  Roe, 
that  "  Hydrocyanic  Acid  of  Scheele's  strength 
will,  if  exhibited  as  soon  as  the  whoop  is  heard, 
effect  a  cure  in  almost  every  case  of  simple  hoop- 
ing-cough. If  the  disease  has  been  going  on  for 
many  weeks,  its  effects  are  not  so  immediately 
felt,  but  nevertheless  it  will  cure  in  most  in- 
stances." * 

The  following  formula  we  are  accustomed  to 
employ  : 

*  A  Treatise  on  the  Nature  and  Treatment  of  Hooping-Cougb,  by  Geo. 
Hamilton  Roe,  M.D.,  Fellow  of  the  Royal  CoUege  of  Physicians,  etc.,  Lon- 
don, pp.  95-6. 


20  NARCOTICS   AND    SEDATIVES. 

3. 

.^  Acidi  Hydrocyanic!,  Medicinalis,  gtt.  xxv. 
Yini  Ipecacuanhae,      .     .     .     .     f.  5  ij. 

Syr.  Tolutan f.  Sj. 

Aquae  Destillatas, f.  S  iij. 

Fiat  mistura,  cujus  sumatur  cochl.  parv.  quarta 
quaque  hora. 

It  is  important  that  its  use  be  entered  upon  as 
soon  as  the  presence  of  the  characteristic  whoop 
determines  the  nature  of  the  disease.  If  the 
breathing  is  oppressed,  or  the  sjrmptoms  present 
indicate  the  existence  of  bronchial  inflammation, 
the  administration  of  the  sedative  should  be  pre- 
ceded by  the  exhibition  of  an  emetic,  and  perhaps 
by  the  application  of  a  few  leeches  to  the  chest. 

If  administered  too  freely,  the  acid  will  produce 
a  greatly  depressing  effect  on  the  vital  powers. 
Should  much  debihty,  therefore,  occur  during  its 
emplo3rment,  the  remedy  should  be  omitted,  and 
mild  tonics,  with  a  more  stimulating  expectorant, 
be  exhibited  for  a  few  days,  when  the  use  of  the 
Hydrocyanic  Acid  may  be  renewed. 

"  The  dose  of  Hydrocyanic  Acid  for  an  infant," 
says  Dr.  Roe,  "  is  about  three-quarters  of  a  minim 
of  Scheele's  strength,  gradually  increased  to  a 
minim,  which  may  be  given  every  fourth  hour  ; 
for  a  child  of  three  years  of  age,  about  one  minim. 


NARCOTICS    AND    SEDATIVES.  21 

gradually  increased,  if  necessary,  to  a  minim  and 
a  half  every  fourth  hour  ;  for  children  of  ten  or 
twelve  years  of  age,  a  minim  and  a  half,  increased 
to  two  minims  every  fourth  hour.  It  is  safer  to 
give  this  medicine  in  small  doses  at  very  short 
intervals,  than  to  run  any  risk  of  producing  too 
great  depression  by  a  large  dose.  The  frequency 
of  its  exhibition  must  depend  upon  the  strength 
of  the  patient  and  the  severity  of  the  attack.  The 
dose  should  be  repeated  when  the  effects  begin  to 
subside,  which,  in  mild  cases,  generally  happens  in 
three  or  four  hoiu*s  ;  but  when  much  fever  is  pre- 
sent, its  influence  is  felt  but  a  very  short  time  ; 
under  such  circumstances,  a  larger  quantity  may 
be  given  and  at  shorter  intervals,  without  any 
ipprehension  of  danger,  so  long  as  the /ever  lasts."  * 

i, 

"^i  Acidi  Hydrocyanici,  Medicinahs,  f.  5  j. 

Liquor,  potassge, f.  S  ss. 

Infus.  Columboe, f.  S  ij. 

MisturoB  Amygdal.,     .     .     .     .     f.  5  iv. 
M.  Capiat  cochl.  minim,  ter  in  die. 

In  cases  of  long-continued  chronic  bronchitis,  the 
physician  occasionally  finds  this  disease  comphcated, 

•  Op.  citat.  pp.  89-90. 


22  NARCOTICS    AND   SEDATIVES. 

with  a  peculiar  irritable  condition  of  the  gastric 
mucous  membrane,  manifested  by  tenderness  of  the 
epigastrium,  a  red  tongue,  frequent  headache,  and 
a  feverish  condition  of  the  sj^stem.  In  such  cases 
where  the  inflammation  has  extended  to  the  mu- 
cous membrane  of  the  stomach,  producing  this  not 
uncommon  form  of  broncho- gastritis,  the  exhibition 
of  the  above  combination,  with  the  hydrocyanic 
acid,  the  alkah,  and  the  bitter  vegetable  infusion, 
will  exert  a  prompt  and  a  decidedly  happy  influ- 
ence on  this  diseased  action. 

Combined  with  the  extract  of  Belladonna,  Hy- 
drocyanic Acid  has  also  been  found  very  useful  in 
the  treatment  of  gastralgia,  and  in  "  irritable  gas- 
tric dyspepsia^ 

The  following  mixture  prepared,  and  a  teaspoon- 
ful  of  the  medicine  administered  three  or  four  times 
daily  in  these  affections,  will,  by  acting  on  the 
nerves  of  the  stomach,  greatly  diminish  their  irrita- 
biUty  : 

6. 

^  Extract.  Belladonnaa,      .     .     .     gr.  x. 

Acidi  Hydrocyanici,  Medicinahs,  gtt.  Ix. 

Tine.  Columbae, 

Syr.  Simp.,       .     .     .     .    .    .    aa.  f.  S  j. 

Aquas  Destillatfie,       .    .    ,    .    f.  S  ij. 
Misce. 


NARCOTICS    AND   SEDATIVES.  23 

The  above  combination  has  Hkewise  been  em- 
ployed with  great  benefit  in  the  treatment  of  spas- 
modic asthma. 

These,  then,  are  some  of  the  useful  combinations 
of  one  of  our  most  important  therapeutic  agents ; 
and  we  can  assure  the  practical  physician  that  not 
only  in  these  affections,  to  which  allusions  have 
been  made,  but  in  the  treatment  of  many  other 
diseases,  he  will  find  these  remedies  invaluable  aids 
in  controUing  diseased  action. 

The  anhijdrous,  or  pure  Hydrocyanic  Acid,  which 
consists  of  one  equiv.  of  Cyanogen,  and  one  equiv. 
of  Hydrogen,  is  of  a  nature  so  exceedingly  poison- 
ous, that  it  cannot  be  employed  with  safety  in 
medicine.  The  medicinal  acid,  which  is  the  prepa- 
ration that  should  always  be  directed  to  be  used  in 
our  prescriptions,  contains  only  2.5  per  cent.  (Uni- 
ted States  Pharmacopoeia)  of  the  pure  acid.  That 
of  the  Apothecaries'  Hall,  London,  contains  3.2 
per  cent. ;  whilst  the  medicinal  Acid  of  the  French 
Apothecaries  is  nearly  equal  to  that  of  the  United 
States  Pharmacopoeia-ir-namely,  2.4  per  cent,  of 
the  pure  acid  of  Gay  Lussac. 

As  the  strength  of  the  difierent  medicinal  acids 
cannot  be  depended  on,  as  being  always  of  the 
same  uniform  power,  it  has  been  proposed  that  the 
Cyanide  of  Potassium  be  substituted  in  medicine 
for  the  Hydrocyanic  Acid. 


24  NARCOTICS    AND   SEDATIVES. 

6. 

^^  Cyanidi  Potassii,       gr.  xxii 

Alcohol.  Officinalis,  f.  5  xi 
Misce. 

This  preparation  of  Cyanogen,  which  possesses 
the  same  medicinal  qualities,  and  is  of  the  same 
strength  with  the  Hydrocyanic  Acid,  is  greatly 
preferred  by  many  practitioners  as  a  therapeutic 
agent,  inasmuch  as  it  can  be  depended  on  as  being 
always  of  a  uniform  strength.  It  may  be  used  in 
the  same  doses  and  under  the  same  circumstances 
in  which  the  Hydrocyanic  Acid  is  administered. 

Besides  the  preceding  formulae,  in  the  combina- 
tion of  which  the  Hydrocyanic  Acid  is  employed, 
we  have  several  other  preparations  into  which 
enters,  either  the  Cyanide  of  Potassium,  or  the 
Hydrocyanic  Acid,  and  which  have  been  found  to 
be  of  great  value  in  practical  medicine.  These  pre- 
scriptions will  be  given  under  the  head  of  expecto- 
rants. 

As  palliatives  in  the  treatment  of  all  forms  of 
neuralgia,  the  narcotics  and  sedatives  are  very 
generally  resorted  to  by  practitioners,  especially 
during  the  paroxysms  of  the  disease.  When  appro- 
priately combined,  their  efficacy  in  these  affections 
is  more  prompt  and  decided  than  when  separately 
administered. 


NARCOTICS    AND    SEDATIVES.  25 


]^  Extract!  Hyoscyami,  5  ss. 

Morphiae  Sulphatis,  gr.  iij. 

Strychnias,     .     .     .  gr.  ij. 

Capsici  pulv.      .     .  5  ss. 

Zinci  Sulphatis,       .  gr.  xv. 
M.  Fiat  massa,  in  pilulas  xxx.  dividenda  ;  capiat 
unam,  ter  quaterve  in  die. 

In  neuralgia,  unattended  by  organic  lesions,  the 
above  pills,  exhibited  every  sixth  or  fourth  hour, 
according  to  circumstances,  will  be  found  to  be  an 
excellent  remedy.  They  have  proved  especially 
serviceable  in  that  form  of  neuralgia  in  which  the 
divisions  of  the  fifth  pair  of  nerves  are  so  frequently 
involved.  Not  only  m  facial  neuralgia,  but  in  all 
cases  where  the  disease  has  been  caused  by  mala- 
ria, this  combination  may  be  administered  with  con- 
fidence that  the  result  will  be  favorable.  The  vale- 
rianate of  iron  conjoined  with  the  extract  of  Hyos- 
cyamus  is  an  excellent  antispasmodic  and  tonic,  and 
may  be  employed  with  great  advantage  for  the 
treatment  of  chorea  and  all  the  neuralgic  affections 
of  anaemic  and  debihtated  females. 


^i  Extract!  Hyoscyami,   5  ss. 
Ferr!  Valerianatis,       5  i. 


26  NARCOTICS    AND   SEDATIVES. 

Fiat  massa,  et  in  pilulas  xxx.  dividenda  ;  qua- 
rum  date  unam  ter  in  die. 

The  Valerianate  of  Iron  and  the  Valerianate  of 
Zinc  are  two  highly  valuable  remedies,  and,  were 
the  therapeutic  powers  of  these  medicines  better 
understood  by  the  profession,  they  would  be  much 
more  extensively  employed  than  they  now  are  for 
the  treatment  of  disease.  The  Valerianate  of  Zinc, 
Dr.  Neligan  says,  is  "  one  of  the  most  valuable 
modern  additions  to  the  Materia  Medica." 

9. 

^t  Extracti  Hyoscyami,  9  iss. 
Zinci  Valerianatis,       3  j. 
Fiant  pilulae  xxx.     Capiat  unam  bis  terve  in  die. 

The  above  pill  is  a  valuable  remedy  in  the  treat- 
ment of  facial  neuralgia,  and,  indeed,  is  equally 
serviceable  in  all  the  nervous  and  neuralgic  affec- 
tions for  which  the  Valerianate  of  Iron  has  been 
advised. 

10. 

^  Extracti  BeUadohnse,  gr.  viij. 
Camphori  pulv.,     .      5  j. 
Quiniae  Disulphatis,     3  ij. 
Misce  ;  Fiant  pilulae  triginti. 


NARCOTICS    AND    SEDATIVES.  27 

These  pills  are  very  effective  in  the  treatment  of 
dysmenorrhoea.  One  pill  may  be  exhibited  every 
hour  or  two  hours  till  the  pain  ceases.  In  females 
of  a  nervous  temperament,  when  painful  menstrua- 
tion occurs,  independent  of  organic  lesions,  these 
pills,  administered  as  above  directed,  seldom  fail  of 
affording  rehef.  In  those  cases  of  dysmenorrhoea 
where  a  tonic  is  not  particularly  indicated,  the  fol- 
lowing are  more  appropriate,  and  are  equally  effi- 
cacious : 

11. 

IBji  Extracti  Belladonnse,  gr.  viij. 
Ipecacuanha  pulv.,      gr.  x. 
Zinci  Sulphatis,      .      5  ss. 
M.  Fiant  pilula3  xxx.,  quarum  capiat  unam  qua- 
que  hora,  donee  leniatur  dolor. 

The  following  pills  are  highly  recommended  by 
an  intelligent  and  experienced  practitioner,  in  the 
treatment  of  leucorrhoea,  occurring  in  anemic  and 
nervous  females  : 

12. 

"Bji  Extracti  Hyoscyami,   5  j. 
Argenti  Nitratis,     .     gr.  x. 
Cantharidis  pulv.,  .     gr.  xii. 
Quiniae  Disulphatis,     9  ij. 
Fiant  pilulae  xl.     Sumat  unam  mane  et  nocto. 


28  NARCOTICS    AND    SEDATIVES 

The  same  physician  advises  the  subjoined  formu- 
la as  a  combination  that  may  be  employed  with 
great  advantage  as  a  diuretic  and  alterative  in  the 
treatment  of  cellular  dropsy  : 


13. 


"Sji  Extract!  Conii,    .      5  j. 
Cantharidis  pulv.,     9  ij. 
Hydrarg.  Submur.,   5  ss. 
Ipecacuanhae  pulv.,  9  j. 
M.  Fiat  massa,  in  pilulas  xl.  dividenda.     Cujus 
capiat  unam  ter  quaterve  in  die. 

A  combination  of  the  extract  of  Belladonna  with 
Quinine  has  been  employed,  very  efficaciously,  in 
the  treatment  of  gastralgia. 


14. 


1^  Extracti  Belladonnae,  9  ss. 
Quiniae  Disulphatis,      5  j. 
M.  Fiant  pilulae  xxx.     Sumat  unam  ter  in  die. 

Professor  C.  0.  Cox,  of  Maryland,  who  has  con- 
tributed some  valuable  prescriptions  to  this  volume 
of  Medical  Formulae,  advises  the  following  mixture 
to  be  administered  in  gastralgia  : 


NARCOTICS   AND    SEDATIVES.  29 

15. 

^  Tinct.  Opii, 
Tinct.  Capsici, 
^ther.  Sulph. 
Tinct.  Camphori,  aa.  5  iij. 
Chloroformi,    .      5  j. 
Fiat  mistura  cujus  capiat  cochl.  parv.  pro  re 
nata. 

The  efficacy  of  the  above  medicine  is  much  in- 
creased if  taken  in  a  wineglass  of  hot  ginger  tea. 

In  that  variety  of  gastralgia  which  is  not  unfre- 
quently  occurring  in  the  course  of  chronic  gastritis, 
we  have  derived  the  greatest  benefit  from  the 
employment  of  the  following  pills  : 


16. 


^  Extracti  Hyoscyami,    5  j. 
Argenti  Nitratis,  .       gr.  x. 
Bismuthi  Subnitratis,  5  iss. 
Fiant  pilula)  xl. :  quarum  sumatur  una  mane  ac 
nocte. 

The  Nitrate  of  Silver  combined  with  some  one 
of  the  sedative  extracts,  may  be  employed  advan- 
tageously in  the  treatment  of  almost  all  chronic 


30  NARCOTICS   AND    SEDATIVES. 

gastric  aflfections.*  In  cases  of  obstinate,  chronic 
gastritis,  or  long  continued  dyspepsia,  we  have 
found  the  following  pills  more  efficacious  than  any 
other  single  remedy.  They  should  be  continued 
for  several  weeks  : 

17. 

]^  Extracti  Conii,  vel  Lupuli,   5  j. 
Argenti  Nitratis,  ...      gr.  x. 
Capsici  pulv. 

Quinia3  Disulphatis,  .     .      aa.  9  ij. 
M.  Fiat  massa,  in  pilulas  xl.,  dividenda.     Capiat 
unam  bis  terve  in  die. 

There  is  a  troublesome  and  often  an  obstinate 
form  of  gastric  irritability,  denominated  by  the 
French  estomac  glaireuse,  in  which  the  patient  occa- 

*  With  regard  to  the  danger  of  "  discoloration  of  the  skin,"  from  the 
internal  administration  of  this  remedy,  it  may  be  proper  to  remark  that 
although  we  have  used  the  Nitrate  of  Silver  very  freely,  not  only  in  topical 
applications  to  the  mucous  membrane  of  the  air-passages,  etc.,  but  have 
administered  it  for  many  years  internally  in  the  treatment  of  diseases  of 
the  alimentary  canal ;  yet  in  no  instance  has  such  an  event  occurred  in  our 
practice.  We  have  seldom  continued  its  daily  internal  use  for  a  period 
longer  than  six  weeks,  or  two  months,  without  intermitting  the  medicine 
for  a  time.  In  doses  of  from  one-eighth  to  one-fourth  of  a  grain,  adminis- 
tered twice  or  thrice  a  day,  the  Nitrate  of  Silver  may  be  given  for  two 
months  without  incurring  the  slightest  risk  of  producing  discoloration. 
Indeed,  Sir  James  Johnson  asserts,  in  his  "Essay  on  the  Morbid  Sensibility 
of  the  Stomach  and  Bowels,"  that  there  is  not  an  instance  on  record  where 
the  complexion  has  been  affected  by  the  medicine  when  restricted  to  three 
months'  administration. 


NARCOTICS   AND    SEDATIVES.  31 

sionally  ejects,  by  eructation,  a  tasteless  watery 
fluid,  and  which  is  accompanied,  often,  by  a  severe 
burning  pain  in  the  epigastric  region.  This  variety 
of  the  disease  is  arrested  with  great  certainty  by 
the  exhibition  of  either  the  preceding,  or  the  fol- 
lowing pills  : 

18. 

i^  Extracti  Lupulinse,       S  j. 
Argenti  Nitratis,     .    •  gr.  x. 
Bismuthi  Subnitratis,   5  iss. 
Quinise  Disulphatis,      3  ij. 
Fiant  pilulae  xl. ;  quorum  sumatur  una  bis  tervei 
in  die. 

In  all  forms  of  chronic  disease,  attended  with 
acute  pain,  as  well  as  in  all  painful  nervous  affec- 
tions, in  the  treatment  of  which,  for  any  cause,  full 
doses  of  opium  are  contra-indicated,  the  following 
combination  may  be  administered  with  great  advan- 
tage : 

19. 

!^  Extracti  Hyoscyami,  gr.  xv. 
Extracti  Stramonii,    gr.  iv. 
Extracti  Humuli,         5j. 
Morphiae  Sulphatis,     gr.  iss. 
M.  Divide  in  pilulas  xxx. ;  quarum  capiat  unam 
omni  semihor^,  donee  leniatur  dolor. 


32  NARCOTICS    AND    SEDATITii.^. 

"  I  have  found,"  writes  Dr.  Porcher,  of  Charles- 
ton, *'  a  combination  of  Sulphate  of  Quinine  and 
Sulphate  of  Morphia  to  be  particularly  beneficial  in 
relieving  pain,  proceeding  from  irregular  nervous 
excitement :" 

20. 

1^  Quiniae  Disulphatis,  9  ij. 
Morphise  Sulphatis,  gr.  x 
Fiant  pilulse  xx.,  quarimi  sumat  unam  pro  re 
nata. 

The  above  pills  may  also  be  administered,  with 
great  advantage,  often,  in  neuralgia  and  rheuma- 
tism. 

Of  the  therapeutic  effects  of  muriate  of  ammonia, 
when  internally  administered,  but  little  is  known, 
as  in  this  manner  it  is  but  rarely  employed  in  this 
country.  With  the  German  physicians  it  has  ob- 
tained a  high  reputation  as  a  good  alterative,  and 
a  promoter  of  healthy  secretions  in  chronic  diseases 
of  the  mucous  and  serous  tissues.  It  not  only  pro- 
motes the  mucous  secretions,  says  Dr.  Sunderlin, 
but  the  cutaneous  exhalations,  and  improves  also 
nutrition  and  assimilation.  Combined  with  a  seda- 
tive and  narcotic,  we  have  found  it  highly  valuable, 
in  allaying  irritation  and  in  promoting  expectora- 
tion, in  the  early  stage  of  phthisis  ; 


NARCOTICS   AND    SEDATIVES.  33 

21. 

^i  Ammonise  Muriatis,   5  ss. 
Opii  pulv.,  .     .     .     gr.  ;x. 
Digitalis  pulv. 

Scillae  pulv.,     .     .     aa.  9j. 
M.  Divide  in  pilulas  xxx.     Sumat  unam  quaque 
sexta  hora. 

Sleeplessness,  occurring  in  hypochondria,  hyste- 
ria, and,  indeed,  in  all  nervous  affections,  may  be 
overcome  with  great  certainty  by  the  administra- 
tion of  the  following  piUs  : 

22. 

]^  Assafoetidge,    .     .      5j. 
Morphise  Sulphatis,  gr.  iij. 
M.     Fiant  pilulas  xxx.,   quarum  exhibe  unam 
vel  duas  hora  de  cubitus. 

The  above  pills — two  to  four  exhibited  daily — 
are  very  efficacious  in  arresting  the  dry  cough 
which  is  occasionally  consequent  on  disordered 
menstruation  in  nervous  females. 


CHAPTER   II. 

TONICS    AND    STIMULANTS. 

Although  these  two  agents  are  here  arranged 
together,  and  are  frequently  combined  in  their 
administration,  yet  they  differ  essentially  in  their 
therapeutic  effects.  Tonics,  although  not  confined 
in  their  action  to  the  muscular  fibre,  are  generally 
defined  to  be  those  "  medicinal  agents  which  restore 
relaxed  and  weakened  muscles  to  their  state  of 
healthful  tone,  which  renew  their  elasticity,  con- 
tractibiUty,  and  tension,"  *  and  thereby  impart 
strength  and  vigor  to  the  whole  system.  Stimu- 
lants, by  increasing  the  sensibihty  and  irritabihty 
of  the  parts  to  which  they  are  applied,  powerfully 
augment,  through  the  nervous  system,  the  organic 
actions.  Stimulants  exalt  the  functions  of  innerva- 
tion and  circulation  without  imparting  permanent 
strength  to  the  system.  Tonics  give  tone  and 
strength  to  the  muscular  and  nervous  system  at 
the  same  time,  without  increasing,  necessarily,  the 

*  Thompson's  Therapeut. 


TONICS   AND    STIMULANTS.  36 

action  of  the  heart.  "  Tonics  give  strength,  stimu- 
lants call  it  forth." 

The  tone  or  energy  of  the  system  which  is  gradu- 
ally acquired  through  the  administration  of  tonics, 
becomes  permanent,  and  is  not  replaced  by  a  con- 
sequent exhaustion  or  depression.  The  introduc- 
tion of  stimulants  into  the  living  body  is  quickly 
followed  by  increased  energy  of  the  vital  actions, 
and  is  succeeded  as  rapidly  by  a  state  of  depression 
or  collapse.  Stimulants  are  not  indicated  when 
inflammation  is  present,  but  "  tonics,  by  imparting 
strength  to  the  capillaries,  operate  benefi.cially  in 
inflammation,  even  when  the  use  of  the  lancet  is 
requisite  to  keep  down  the  action  of  the  heart."  * 
Both  tonics  and  stimulants  may  produce  their 
effects  on  the  system,  by  making  their  impression 
chiefly  on  the  stomach,  or  by  operating  through 
the  medium  of  the  blood,  or  through  the  medium 
of  the  nerves. 

As  tonics,  strictly  speaking,  are  neither  stimu- 
lant nor  sedative,  they  may  be  appropriately,  and, 
often,  very  usefully  combined  with  either  stimu- 
lants or  sedatives.  In  many  cases,  where  tonics 
are  indicated,  and  yet  from  some  cause  are  not 
well  borne,  they  may  be  administered,  especially 
the  martial  preparations,  with  much  safety,  and 
often  with  great  advantage,  by  combining  them 

*  Thompaon. 


36  TONICS   AND    STIMULANTS. 

with  some  of  the  peculiarly  sedative  medicines. 
The  different  forms  of  iron,  whether  employed  as 
found  in  the  natural  chalybeates,  or  in  the  arti- 
ficial preparations  of  the  chemist,  make  their,  pri- 
mary impression  on  the  digestive  organs,  augment- 
ing, ultimately,  the  power  of  the  secretory  and 
excretory  systems,  and  rousing  the  nutritive  faculty 
in  every  part  of  the  body. 

The  following  combination  of  a  chalybeate 
with  a  stimulant  and  a  sedative  has,  for  many 
years  in  our  hands,  proved  a  most  valuable  tonic, 
particularly  when  administered  during  convales- 
cence from  disease,  and  in  all  debilitated  and 
anaemic  cases. 


23. 

IBji  Extract!  Conii,     .  5  j. 

Sesqui-oxydi  Ferri,  5  ij. 

Tinct.  ColumbaB,  .  f.  5  iss. 

Syr.  Tolutan.,       .  f.  S  ss. 

01.  Gaultheriae,    .  gtt.  x. 

Aquae  fontanae,    .  f.  B  ij. 
Fiat  mistura ;  cujus  sumat  coch.  parv.  mane  ac 
nocte. 

Or  the  following  may  be  substituted : 


TONICS   AND    STIMULANTS.  37 

24. 

"E^  Sesqui-oxydi  Ferri, 

Extract!  Taraxici,    aa.  S  ss. 
Yini  Sherii,     .     .     f .  S  vj. 
Tinct.  Gaultheriae,    S  ss. 
Aqu88  font.     .     .     f  S  iv. 
M.  Capiat  coch.  magn.  bis  in  die. 

The  following  is  a  very  excellent  tonic,  and  may 
be  exhibited  whenever  any  of  the  ferruginous  pre- 
parations are  indicated. 


25. 


^  Ferri  Citratis,     ...      5  ij. 
Syr.  Citri  vel  Aiirantiae, 
Aquae  Menth.  Pip.,      .     aa.  f  Sij. 
Aquae  purse,        .     .     .     f.  S  iv. 
M.  Exhibe  cochlearium  parvum  ter  quaterve  in 
die. 

In  young  anaemic  females,  with  indications  of  a 
chlorotic  condition  of  the  system  ;  and  also  in 
children  of  strumous  habits,  the  Phosphate  of  Iron, 
exhibited  in  combination  with  the  Sulphate  of 
Quinine,  is  a  therapeutic  agent  of  great  value. 


38  TONICS  AND   STIMULANTS. 

26. 

^  Ferri  Phosphatis,  .      5  j. 
QuiniaB  disulphatis,      gr.  xii. 
M.   Fiant  pulv.  xii.,  quarum  capiat  unam  bis 
terve  in  die. 

A  physician  of  great  experience,  and  celebrated 
for  his  successful  treatment  of  diseases  of  females, 
has  employed  for  many  years,  and  with  much 
advantage,  the  subjoined  combination  of  an  altera- 
tive and  a  tonic  in  the  management  of  certain 
forms  of  uterine  disease. 


27. 


^  Syrup.  Ferri  lodidi,     .      5j. 
Tinct.  Actaeae  Racemsose,  f  5  v. 
Tinct.  Rad.  Aconiti,     .     t  5  iij. 
Fiat  mist,  cujus  cap.  gtt.  xx.  ter  in  die. 

We  have  seen  engorgement  of  the  os  tincse  and 
non-malignant  induration  of  this  organ,  disappear 
rapidly  under  the  persevering  internal  administra- 
tion of  the  above  tonic  ;  while,  at  the  same  time, 
the  following  ointment  was  apphed  once  a  week, 
by  means  of  friction,  with  the  finger,  to  the  indu- 
rated OS. 


TONICS  AND   STIMULANTS.  39 

28. 

^  Extract!  Hyoscyami, 
Extract!  Conii, 
Extract!  Belladonnge,  aa.  p.  e. 

To  each  ounce  of  which  mixture  add  one  drachm 
of  Iodide  of  Potassa — mix  thoroughly,  and  apply 
as  above. 

29. 

"S^  Ferri  Sulphatis,      5  ij. 
Potassse  lodidi,      5  iss. 
Tinct.  Colombse, 
Syrup.  Zingiberis,  aa.  f.  S  ij. 
Fiat  mist,  capiat  coch.  parv.  ter  in  die. 

This  mixture  may  be  exhibited  with  advantage 
whenever  we  desire  to  promote  the  absorption  of 
glandular  enlargements,  and  in  all  cases  where  a 
tonic  and  an  alterative  are  indicated. 

Not  unfrequently  the  general  practitioner  will 
encounter  cases  of  obstinate  intermittent ;  and  of 
imcontrollable  neuralgic  affections,  which  will  resist, 
altogether,  the  effects  of  the  ordinary  antispas- 
modics, when  singly  administered.  In  such  in- 
stances, we  have  often  succeeded  perfectly,  by  the 
combination  and  exhibition  of  a  vegetable  and 
mineral  tonic — as  the  following  : 


40  TONICS   AND   STIMULANTS. 

30. 

^i  Liquor.  Potassae  Arsenitis,  f.  5  iss. 
Tinct.  Cinchonae,        .     .     f .  S  iij. 
Syr.  Aurantiae,      .     .     .     f.  S  j. 
M.  Hujus  mist.,  sumat  cochl.  min.  bis  terve  in 
die. 

During  the  last  two  years,  intermittent  fevers 
have  occurred  more  frequently,  in  some  parts  of 
this  city  and  in  the  vicinity  of  the  city,  than  for 
many  previous  years.  In  some  of  these  cases, 
where  the  disease  has  proved  obstinate,  not  yield- 
ing to  large  doses  of  Quinine,  long  continued,  we 
have  found  it  to  be  promptly  arrested  by  the 
administration  of  a  teaspoonful  of  the  following 
mixture,  twice  or  thrice  a  day — the  last  dose 
being  administered  a  short  time  before  the  period 
of  the  anticipated  paroxysm. 

31. 

^  Quini93  Disulph.,       .     .      5  j. 
Liquor.  Potassae  Arsenitis,  f.  5  ij. 
Acidi  Sulph.  Aromat.,    .     f.  5j. 
Tinct.  Cinch.  Co., 
Syr.  Zingib.,    .      .     .     .     aa.  f.  B  ij. 

When  the  preparations  of  Arsenic  are  employed, 
it  is   safest  to   give  the  medicine   after  a  meal. 


TONICS   AND    STIMULANTS.  41 

When  thus  exhibited,  larger,  or  more  effectual 
doses  may  be  given  with  more  safety,  than  when 
taken  fasting.  Should,  however,  gastric  irritation 
arise,  under  its  use,  or  swelling  and  stiffness  of  the 
eyehds  occur,  the  medicine  should  be  immediately 
discontinued. 

Should  it  from  any  cause  be  desirable  to  adminis- 
ter these  remedies  in  the  form  of  a  piU,  we  may 
employ  the  following  formula  : 


32. 


^i  Acidi  Arseniosi,        gr.  ij. 
Quiniee  Disulphatis,  5  j. 
Conserv.  Rosas,    .      5  ss. 
Misce  optime,  et  fiat  massa,  in  pilulas  xxx.  di- 
videnda  ;  sumat  unam  bis  quotidie. 

Arsenic  is  not  only  a  valuable  antiperiodic,  but 
it  is  a  most  powerful  alterative,  and  has  proved 
efficacious,  when  judiciously  administered,  in  many 
cases  of  obstinate  disease.  A  late  number  of  the 
Edinburgh  Medical  Journal  (May,  1858),  contains 
a  highly  valuable  paper  on  the  "  Physiological  and 
Therapeutical  effects  of  Arsenic,"  by  Dr.  James 
Begbie,  in  which  the  author  expresses,  in  strong 
terms,  his  confidence  in  Arsenic  as  a  most  useful 
and  available   therapeutical  agent,   "  powerful  in 


42  TONICS   AND   STIMULANTS. 

many  intractable  affections,  and  exercising  a  com- 
manding influence  over  ailments  hitherto  considered 
incurable."  The  diseases  in  which  this  remedy  has 
proved  to  be  particularly  ejfficacious,  are,  neuralgia, 
chorea,  chronic  rheumatism,  and,  indeed,  all  that 
class  of  diseases  which  originate  in  the  rheumatic 
diathesis.  "  The  papular,  pustular,  vesicular  and 
squamous  affections,  in  their  chronic  and  non-con- 
tagious forms,  are  especially  amenable  to  its  influ- 
ence "  (p.  975).  Under  its  use  in  the  treatment  of 
numerous  and  various  diseases.  Dr.  Begbie  affirms, 
that  an  improved  digestion  and  a  better  appetite 
invariably  occur  ;  and  in  no  instance  has  he  ob- 
served any  injurious  consequences  to  result  from 
its  emplojTiient. 

The  Liquor  Arsenicalis  of  the  pharmacopoeia,  is 
the  preparation  ordinarily  employed  for  securing 
the  remedial  effects  of  the  medicine,  although  Dr. 
B.  frequently  administers  Arsenic  in  combination 
with  Quinine,  Iodine,  Colchicum,  etc.  In  exhibit- 
ing the  Liquor  Arsenicalis,  it  is  given,  by  him,  to 
adults  in  doses  of  five  drops  of  the  solution,  after 
each  meal,  largely  diluted  with  water — the  medi- 
cine being  increased  one  drop  every  third  day, 
until  the  physiological  action  of  the  reniedy  is 
manifested,  such  as  itchiness  and  swelling  of  the 
eyehds  ;  a  silvered  tongue,  or  tenderness  of  the 
epigastrium.     The  dose,  on  the  occurrence  of  any 


TONICS   AND   STIMULANTS.  43 

of  these  symptoms,  should  be  duninished,  or  the 
intervals  of  its  administration  lengthened. 

It  is  in  the  persistent  use  of  Arsenic — ^in  cases  of 
obstinate  and  intractable  disease — that  its  highest 
beneficial  effects  are  ultimately  obtained.  But, 
throughout  the  entire  use  of  this  mineral,  its  poi- 
sonous action  should  be  guarded  against,  by  limit- 
ing its  exhibition  to  the  production  of  those  symp- 
toms only  which  indicate  its  earhest  physiological 
action. 

We  have  had,  recently,  much  experience  in  the 
use  of  the  different  preparations  of  Manganese,  and 
have  become  fully  satisfied  that  this  mineral  tonic, 
in  its  different  combinations,  will  prove  a  most 
valuable  addition  to  our  pharmaceutic  preparations. 

The  presence  of  Manganese  in  the  blood  has  been 
fully  estabhshed  by  the  experiments  of  MM.  Mil- 
lou,  Hannon,  and  others  ;  and,  recently,  M.  Burin, 
in  a  memoir  presented  to  the  French  Academy 
of  Medicine,  has  given  an  analysis,  by  which 
he  shows  the  amount  of  Manganese  in  the  blood 
globules,  and  exhibits  the  condition  in  which  it 
exists.*  It  is,  indeed,  as  constant  an  ingredient  of 
this  fluid,  in  its  normal  condition,  as  iron,  and  it  is 
well  known  that  a  deficiency  in  quantity,  of  both 
these  metals,  may  be  observed  in  the  blood  in 

•  BulL  de  Th^rapeutiqae. 


44  TONICS   AND   STIMULANTS. 

many  cases  of  anaemia,  chlorosis,  tuberculosis,  etc.  ; 
and  hence  the  employment  of  Manganese  is  proper, 
in  most  instances,  where  the  administration  of  iron 
is  indicated.  It  can  be  administered,  moreover, 
with  entire  safety  in  those  cases  in  which  haemop- 
tysis is  an  occasional  symptom.  Frequently,  both 
remedies  may  be  given  in  combination  with  great 
advantage. 

The  most  important  preparations  of  Manganese, 
for  pharmaceutical  purposes,  are  the  Phosphate, 
the  Malate,  and  the  Iodide  of  Manganese. 

After  the  subjoined  formula,  we  have  adminis- 
tered, in  tuberculosis,  to  a  large  number  of  patients, 
the  Phosphate  of  Manganese,  with  most  favorable 
results. 

33. 

^  Manganesii  Phosphatis,  5  ij. 
Tinct.  Cinchonae,  .     .     f.  S  iij. 
Syr.  Sarsae,       .     .     .     f.  S  iv. 
Mucil.  Acacise,       .     .     f.  S  j. 
01.  Gaultherise,     .     .     gtt.  xx. 
Fiat  mistura,  cujus  sumantur  coch.  duo  vel  tria 
minima  bis  terve  in  die. 

Or  we  may  administer,  under  similar  circum- 
stances, and  to  the  same  amount,  the  Manganeso 


TONICS  AND   STIMULANTS.  45 

combined  with  some  of  the  preparations  of  Iron  ; 
as  in  the  following  : 

34. 


lEjs  Manganesii  Phosphatis, 

5iss. 

Ferri  Phosphatis, 

5  iij. 

Tinct.  Colombo,    .     . 

f.Sij. 

Syr.  Tolutan.,    .     .     . 

f.  S  iv. 

Ess.  Gaultheriaa,     .     . 

f.5j. 

These  mixtures  should  be  kept  in  well  closed  bot- 
tles, and  as  the  Manganese  is  not  altogether  solu- 
ble, the  medicine  should  be  shaken  before  being 
administered. 

The  Malate  of  Manganese  is  considered  by  some 
practitioners  a  more  ehgible  preparation,  inasmuch 
as  it  is  quite  soluble,  and  the  base* of  the  salt  is  in 
the  form  of  protoxide,  the  acid  being  easily  di- 
gested. 

35. 

"Eji  Manganesii  Malat.,   5  ij. 
Tinct.  Cinch.,       .     f.  S  ij. 
Syr.  Simp.,     .     .     f .  S  iv. 
Ess.  Limon.,    .     .     f  5  j. 
Fiat  mistura,  date  coch.  parv.  mane  ac  nocte. 

.  The  Iodide  of  Manganese  is  an  efficient  remedy  in 
the  treatment  of  glandular  enlargements,  especially 


46  TONICS   AND   STIMULANTS. 

those  of  the  neck  and  of  the  spleen,  in  constitu- 
tional syphihs,  and  in  the  antemia  arising  from  scro- 
fula and  from  cancerous  affections. 

It  may  be  administered  in  the  form  of  pills  ;  or, 
as  a  mixture  in  the  following  formula  : 

36. 

^  Manganesii  lodid.,   5  ij. 
Tinct.  Cardamom.,  f.  S  j. 
Syr.  Sarsa.,     .     .     f  5v. 
M.  Sumat  coch.  parv.  bis  terve  in  die. 

In  a  paper  pubhshed  in  a  late  number  of  the 
BvMetin  de   Therapeutique,   M.  Petriquin  recom- 
mends a  combination  of  Manganese  and  Iron,  as  a 
highly  valuable  agent  in  the  treatment  of  disease. 
He   has   found  these  combined  medicinal  bodies 
especially  useful  in  blood   diseases,  such  as   the 
chloro-ansemia,  after  haemorrhage,  operations,  me- 
trorrhagia, etc.     In  the  chlorosis  which  appears 
about  puberty,  in  that  also  which  occurs  at  the 
critical  period  of  women,  especially  when  profuse 
haemorrhage  prevails,   and  in  the  depraved  state 
of  the  blood,  which  succeeds  intermittent  fevers, 
M.  Petriquin  has  found  the  Ferro-Manganese  pre- 
parations of  remarkable  efficacy. 

We  have  spoken  of  the  Phosphate,  the  Malate, 
and  the  Iodide  of  Manganese  as  being  among  the 


TONICS   AND   STIMULANTS.  47 

most  important  of  the  pharmaceutical  preparations 
of  this  metal.  With  some  practitioners,  the  Car- 
honate  of  Manganese,  in  combination  with  the  Car- 
bonate of' Iron,  is  considered  a  valuable  therapeu- 
tic agent.  These  two  Carbonates,  combined  in 
equal  quantities,  and  administered  in  doses  of  from 
five  to  ten  grains  daily,  constitute  a  favorite  reme- 
dy with  a  distinguished  practitioner  of  Massa- 
chusetts. 

37. 

"Bf  Manganesii  Carb. 

Ferri  Carb.,      .     .     aa.  5  j. 
Sacchar.  Alb.  Pulv.,  5  ij. 
Misce  et  in  piilv.  xv.  divide,  quorum  cap.  ij. 
vel.  iij.  quaque  die. 

Should  a  liquid  preparation  of  these  remedies  be 
preferred,  they  may  be  exhibited,  combined  with 
some  vegetable  tonic,  as  in  the  subjoined  formula  : 

38. 

ISf  Manganesii  Carb. 

Ferri  Carb.,    .     aa.  5  ij. 
Tinct.  Columbae, 
Syr.  Sarsa.  Co.,  aa.  f.  %  iij. 
M.  Capiat  coch.  min.  bis  in  die. 


48  TONICS    AND    STIMULANTS. 

This  combination  of  the  Carbonate  of  Manganese 
and  the  Carbonate  of  Iron  is  especially  appropriate 
for  the  improvement  of  that  condition  of  the  sys- 
tem which  is  attended  with  an  ulcerative,  action  of 
mucous  membranes.  In  the  treatment  of  that  often 
troublesome  aflfection,  ulcerated  sore  mouth,  this 
Ferro-Manganese  preparation,  it  will  be  found,  will 
prove  to  be  particularly  efficient : 

39. 

^  Manganesii  Carb.,  5  j. 

Ferri  Carb.,     .     .  5  iss. 

Potass.  lodid.,      .  5  ij. 
Tr.  Gentianse  Co., 

Syr.  Sarsa.  Co.,    .  *  aa.  f.  S  iij. 
Fiat  mistura.     Capiat  cochleare  parvum  bis  in 
die. 

In  mesenteric  obstructions,  and  for  the  discussion 
of  glandular  swellings  in  any  part  of  the  body,  the 
above  preparation  is  a  valuable  remedy. 

40. 

"Within  a  few  years.  Fusel  Oil  has  been  much 
employed  by  some  experienced  practitioners,  in 
New  England,  by  whom  it  is  spoken  of  as  a  most 
valuable  therapeutic  agent.     Fusel  Oil,  or  Grain 


TONICS   AND   STIMULANTS.  49 

Oil,  is  the  Hydrated  Oxyde  of  Amyle,  and  is  ob- 
tained in  the  distillation  of  Alcohol. 

"  This  remedy,"  writes  Dr.  Henry  J.  Bowditch, 
of  Boston,  who  has  communicated  valuable  informa- 
tion to  the  author  on  its  use,  "  was  first  brought  to 
my  notice  by  Dr.  Wyman,  of  Cambridge,  who,  on 
theoretical  grounds,  suggested  it  to  the  profession 
as  a  paUiative  in  tuberculous  cases. 

"  For  the  past  few  years,  I  have  used  it,  almost 
to  the  total  exclusion  of  Cod-Liver  Oil.  It  pro- 
duces, at  its  exhibition,  stimulating  effects,  similar 
to  those  caused  by  the  coarser  liquors.  It  also 
excites  nutrition,  so  that  patients  grow  fat  as  when 
using  Cod-Liver  Oil. 

"  I  have  noticed,  Ukewise,  in  many  instances, 
that  it  seems  directly  to  influence  the  cough,  almost 
like  an  opiate — checking  it  and  lessening  the 
amount  of  sputa.  In  some  persons  it  produces  nau- 
sea ;  in  others  it  causes  fever.  In  such  circum- 
stances I  lessen  the  dose  or  discontinue  the  remedy. 

"  But  I  have  been  as  much  pleased  with  the 
effects  of  this  remedy  in  another  series  of  cases, 
viz. :  in  those  poor,  miserable,  emaciated,  whining 
children,  who  are  so  thin  that  one  can  see  the 
bones  almost  as  well  through  the  thinned  skin,  as 
if  they  were  actually  exposed  to  view.  I  have 
seen  such  individuals  (even  when  there  were  some 
suspicions  of  pulmonary  or  abdominal    disease), 

4 


50  TONICS   AND   STIMULANTS. 

arise  with  an  extraordinary  degree  of  elasticity, 
marked  even  from  the  first  dose.  A  week  changes 
them  very  much,  and  sometimes  a  month  restores 
the  little  creatures  to  health  and  plumpness.  Of 
course,  I  do  not  mean  to  say  that  it  always  pro- 
duces this  effect,  but  I  have  seen  it  successful  so 
often,  that  I  may  consider  it  as  my  '  favorite  reme- 
dy.' In  conclusion,  let  me  add,  that  my  doses  vary 
from  half  to  one  drop  for  a  child  five  or  six  months 
old,  up  to  five  or  ten  drops  for  an  adult.  I  give  it 
in  syrup  to  a  child,  and  often  in  a  httle  whisky 
and  water  to  an  adult." 

The  alkaloid,  and  the  extract  of  Nux  Vomica,  are 
ordinarily  arranged  under  the  head  of  Excitants. 
We  have  employed  these  preparations,  however, 
with  great  advantage,  in  cases  where  both  tonics  and 
excitants  were  indicated.  Strychnia  and  the  ex- 
tract of  Nux  Vomica,  as  therapeutic  agents,  it  is 
generally  supposed,  produce  the  same,  or  nearly 
the  same  effect  upon  the  animal  system.  By  some 
practitioners  it  is  beheved  that  the  extract  deter- 
mines more  to  the  head  than  Strychnia.  This  salt 
may  be  exhibited  in  appropriate  doses  without  pro- 
ducing any  obvious  effect  on  the  cerebral  circula- 
tion. The  alkaloid,  therefore,  should  be  preferred 
in  those  cases  where  we  would  excite  the  powers 
of  the  nervous  system  without  increasing  the  action 
of  the  brain. 


TONICS    AND   STIMULANTS.  61 

41. 

"E^  Extract.  Nucis  Yomicae,  gr.  xxxii. 
Tinct.  Cardamom., 
Syr.  Zingib.,    .      .     .     aa.  f.  S  j. 
Aquae  font.,      .     .     .     f.  5  ij. 
Fiat  mistura,  cujus  cap.  gtt.  xx.,  vel  xxx.,  bis 
terve  in  die. 

In  chronic,  gastric  affections,  with  diminished 
energy  of  the  digestive  powers,  the  administration 
of  the  above  preparation  will,  in  many  cases,  by 
improving  the  appetite,  and  increasing  the  powers 
of  assimilation,  impart  tone  and  energy  to  the 
whole  system. 

With  one  of  our  oldest  and  most  experienced 
physicians  the  following  pills,  exhibited  one  night 
and  morning,  is  a  favorite  remedy  in  chronic  gas- 
tric affections,  chronic  diarrhoea,  etc.  : 

42. 

"^i  Extract.  Nucis  Yomicae,  gr.  iv. 
Extract.  Opii,   .     .     .     gr.  vi. 
M.  Fiat  massa,  et  m  pilulas  xvi.  dividenda. 

Under  similar  circumstances  Prof.  Cox,  of  Mary- 
land, recommends  the  following  as  a  valuable 
remedy  : 


52  TONICS  AND   STIMULANTS. 

43. 

^  Nucis  Yomicse,  .      9  ij. 
Argent.  Oxydi,  .     gr.  xvi. 
Extract.  Gentianae,  5  iss. 
M.  Fiat  massa  et  in  pil.  Ix.  div.     Sumat  unam 
ter  in  die.     Vel : 


44. 

^t  Bismuth.  Subnit.,    .      5  j. 

Rad.  Columbae  Pulv.,   g  ss. 

Acaciae  Pulv.,  .  .  5  ij. 
M.  Fiat  massa,  in  pilulas  xx.  divide. 
To  be  taken  as  the  above. 


On  account  of  the  great  insolubility  of  Strychnia, 
this  alkaloid  is  generally  administered  in  the  form 
of  pills,  the  salt  being  made  up  with  the  conserve 
of  roses,  or  the  extract  of  Gentian  or  of  Liquorice. 
It  is  of  importance,  in  the  exhibition  of  Strychnia, 
in  many  cases,  gradually  to  increase  the  dose  ;  but 
this  is  with  difficulty  effected  when  the  medicine 
is  made  up  in  the  form  of  pills.  A  perfect  solution 
of  the  salt  may  be  obtained  in  the  following  man- 
ner ;  and  we  would  advise  that  prescriptions  be 
made  up  from  such  a  solution  : 


TONICS  AND  STIMULANTS.  53 

45. 

Solution  of  Strychnia. 

"Bf  StrychniaB,  .  gr.  xii. 

Acidi  Acetici,  gtt.  Ix. 

Alcohol,       .  f.  Sj. 

Aqu8B  font.,  f.  5  xi. 
M. 

The  above  solution  may  be  administered  in  doses 
of  from  ten  to  thirty  drops,  twice  or  thrice  daily. 
Beginning  with  the  smallest  number  of  drops,  and 
gradually  increasing  the  dose,  the  medicine  may  be 
continued  until  its  specific  effects  on  the  system  are 
slightly  induced,  when  the  remedy  should  at  once 
be  arrested  for  a  few  days,  and  its  administration 
be  recommenced,  if  necessary,  beginning  again 
with  the  minimum  dose.  We  have  foimd  it  a  most 
valuable  and  efficient  remedy  in  some  obstinate 
forms  of  neuralgia. 

The  following  preparation  may  be  often  em- 
ployed with  great  advantage  in  the  treatment  of 
chronic  gastric  irritation : 

46. 

^  Solutio.  Strychniae,      .      f.  5  S8. 
Tinct.  Cardamom.  Comp.,  f.  S  iiiss. 
M.  Cap.  coch.  parv.  ter  in  die. 


54  TONICS   AND    STIMULANTS. 

A  physician  of  much  experience  in  the  manage- 
ment of  malarious  diseases,  recommends  the  follow- 
ing mixture  as  a  most  efficient  remedy  in  the  treat- 
ment of  obstinate  cases  of  intermittent  fever 


47. 


"Eji  Solutio.  Strychnige,     .     .     f .  5  ij. 
QuinsB  Disulphatis,     .     .     5  ss. 
Tinct.  Ferri  Sesquichloridi,  f.  S  ss. 
Aquae  fontanoB,       .     .     .     f .  S  iss. 
Fiat  mistura,  cujus  sumatur  coch.  parvum  quartsl 
quaque  horS,,  intermissionis  tempore. 


An  eminent  German  physician,  M.  Frisch,  has 
recently  recommended  a  similar  combination,  in  the 
treatment  of  intermittents,  when  the  Sulphate  of 
Quinia  fails.  This  physician  prescribes  "  from  six 
to  ten  grains  of  the  rasped  seed  mixed  with  two 
ounces  of  the  Cinchona  Bark,  or  with  twelve  grains 
of  the  Disulphate  of  Quinia,  to  be  taken  in  divided 
doses  in  the  intervals  of  the  paroxysms."  In  some 
forms  of  neuralgia  we  have  derived  more  prompt 
and  decided  effects  from  the  use  of  the  Strychnia, 
when  administered  in  combination  with  an  anodyne, 
as  in  the  following  combination  : 


TONICS   AND   STIMULANTS.  65 

48. 

"^  Solutio.  Stryclmiae,  .  .  .  f.  5  iij. 
Solutio.  Morphiae  (Majendie),  f.  5  iss. 
Tinct.  Gentianae,   .     .     .     .     f.  S  ij. 

Syr.  AcaciaB, f .  S  iss. 

M.  Exhibe  cochleare  parvum,  quaterve  ter  in  die. 

A  distinguished  physician  of  Maryland,  highly 
recommends  the  following  as  a  very  useful  anti- 
periodic  : 

49. 

^  Quiniae  Disulphatis,   5  ss. 
Piperin.  Pulv.,     .      gr.  xv. 
Strychniae,       .     .     gr.  j. 
M.  Fiat  massa  et  in  pil.  xii.  div.     Sumat  unam 
ter  in  die. 

60. 

In  certain  forms  of  impotence,  writes  an  expe- 
rienced practitioner,  of  South  Carohna,  proceeding 
from  a  feeble  action  of  the  erector  muscles,  "  I 
have  found,  in  many  cases.  Strychnia  to  have  an 
excellent  effect ;  I  administer  it  in  doses  of  a  12  th 
of  a  grain,  three  times  a  day." 

Not  only  in  the  diseases  already  named,  have  the 


56  TONICS  AND   STIMULANTS. 

extract  of  Nux  Vomica  and  Strychnia  proved  use- 
ful, but  in  hemiplegia,  in  general  paralysis,  an^J  in 
spasmodic  asthma,  great  advantage  has  been  de- 
rived from  the  use  of  these  remedies.  In  adminis- 
tering Strychnia  in  paralysis  we  obtain  the  greatest 
benefit  from  its  use,  if  the  dose  is  gradually  in- 
creased, until  shght  tetanic  movements  of  the  para- 
lytic hmbs  are  produced. 

Administered  alone,  or  in  combination  with  the 
Tincture  of  Lobeha,  Strychnia  has  proved  service- 
able, in  some  instances,  in  the  treatment  of  spas- 
modic asthma. 


61. 


^  Solutio.  StrychniaB, 

Tinct.  Lobehse,  .     aa.  5  ij. 
Syr.  Tolutan.,     .     5  iss. 
M.  Ft.  mistura,  cujus  date  coch.  parv.  ter  qua- 
terve  in  die. 


In  one  very  common  form  of  dyspepsia,  attended 
with  derangement  of  the  bihary  organs,  the  sub- 
joined combination  constitutes  a  most  valuable 
remedy,  administered  in  doses  of  one  teaspoonful 
three  times  a  day. 


TONICS  AND   STIMULANTS.  57 

62. 

"E^  Hydrarg.  Bichloridi,     gr.  iv. 

Tinct.  Nucis  Yomicse, 

Vel  Solutio.  Strych.,    5  ss. 

Tinct.  Rhei  Comp.,  .    S  iss. 

Syr.  Aurantiae,     .     .    5  ij. 
M. 

In  the  administration  of  so  powerful  a  remedy 
as  Strychnia,  much  caution  should  always  be  ob- 
served. As  it  is  one  of  the  most  valuable  of  our 
medicinal  agents,  every  practitioner  should  become 
acquainted  with  its  therapeutic  powers,  and  with 
its  best  modes  of  administration.  By  commencing 
with  small  doses,  and  gradually  increasing  the 
amount,  the  remedy  may  be  continued  with  safety, 
until  shght  tetanic  twitchmgs  of  the  muscles  are 
produced. 

In  one  case  of  most  obstinate  and  long-continued 
neuralgia,  occurring  in  a  lady  of  this  city,  we  ad- 
ministered the  Strychnia,  and  gradually  increased 
the  dose,  until  the  spasmodic  movements  of  the 
muscles  were  quite  apparent,  but  without  any 
abatement  of  the  disease.  Commencing  with  the 
original  dose,  the  medicine  was  again  administered 
up  to  the  same  point ;  and  this  was  done  for  the  third 
time,  and  with  the  effect  of  completely  arrestmg 


68  TONICS   AND   STIMULANTS. 

the  disease.  In  most  cases,  however,  it  will  not 
be  necessary  to  continue  the  remedy  until  these 
tetanic  movements  are  manifested. 

Other  remedies  have  been  employed  with  advan- 
tage in  the  treatment  of  neuralgia.  Prof.  Harvey 
Lindsly,  of  Washington,  recommends  highly  the 
following.  One  pill,  he  affirms,  administered  every 
four  hours  and  perseveringly  taken,  has  proved 
very  efficient  in  his  hands. 

63s 

]^  Extract.  Aconiti,  gr.  x. 
Acidi  Arseniosi,  gr.  j. 
Quiniae  Disulph.,  5  ss. 
M.  Fiat  massa,  et  in  pil.  xx.  div 

The  addition  of  Morphia  to  the  above  pill  is  of 
advantage  in  some  cases.  The  same  physician 
reconmiends  the  following  in  neuralgia  : 

54. 

^  Extract.  Belladon.,  gr.  x. 
Ferri  Pulv., 

Quiniae  Disulph.,     aa.  9  j. 
M.  Fiat  mass,  et  in  pil.  xx.  divid.  quarum  cap. 
iv.  vel  V.  quaque  die. 

In  neuralgia  of  the  kidneys  and  stomach,  Dr. 


TONICS   AND   STIMULANTS.  59 

Cox,  of  Maryland,  advises  the  employment  of  the 
following  combination  : 

65. 

"S^  Bi-Carb.  Potass.,   .    5j 

Acidi  Hydrocianici,  gtt.  xxiv. 
Sol.  Sulph.  Morph.,  gtt.  xxiv. 
Aquae  Camphori,   .    S  iv. 
M.  Fiat  mistura,  cujus  capiat  coch.  parv.  ij.  pro 
re  nata. 


CHAPTER  III. 

EXCITANTS   AND   ALTERATIVES. 

In  the  therapeutical  classification  of  medicinal 
agents,  by  Dr.  Thomson,  Iodine  and  its  compoimds 
are  arranged  under  the  head  of  excitants. 

Uncombined,  Iodine  is  a  powerful  excitant, 
stimulating  the  tissues  of  the  organs  and  accelerat- 
ing their  action.  In  some  of  its  combinations,  it 
acts  with  much  energy  upon  the  capillary  and  secre- 
tory systems  ;  combined  with  Mercury  it  is  a  most 
valuable  alterative,  and  in  combination  with  Potas- 
sium it  not  only  stimulates  the  whole  of  the  glandu- 
lar system,  but  acts  in  a  special  manner  upon  the 
kidneys.  It  is  Dr.  Clark's  opinion,  that  the  action 
of  Iodine  upon  the  animal  economy  resembles  in  a 
great  degree  that  of  Mercury.  In  some  respects 
the  therapeutical  effects  of  these  two  remedies  may 
be  similar.  The  action  of  the  tissues  of  the  organs 
is  accelerated,  and  the  excretory  system  is  pro- 
moted, it  is  true,  by  both  remedies,  but  not  in  the 
same  degree.  Paleness,  or  blanching,  is  frequently 
produced  by  a  course  of  Mercury,  an  effect  which 


EXCITANTS   AND   ALTERATIVES.  61 

has  been  ascribed  to  the  duninished  number  of  red 
globules  of  the  blood ;  whilst,  on  the  other  hand, 
an  increased  nutrition  of  the  body,  or  emhowpoint, 
is  the  frequent  result  of  the  employment  of  Iodine. 

We  have  found  no  other  general  remedy,  to 
compare,  in  its  beneficial  effects,  with  that  of  Iodine 
and  its  compounds  in  the  commencement  of  the 
treatment  of  follicular,  and  other  diseases  of  the 
air-passages. 

In  uncompHcated  foUiculitis  of  the  pharyngo- 
laryngeal  membrane,  the  administration  of  the  fol- 
lowing mixture,  conjoined  with  the  topical  appHca- 
tions  of  a  solution  of  the  crystals  of  Nitrate  of  Sil- 
ver to  the  diseased  membrane,  wiU,  in  most  cases, 
effect  a  speedy  cure  : 

56. 

^  Potass.  lodid.,    .      5  ij. 
Tmct.  Rhei,       .     f.  S  i.    . 
Syr.  Sarsa.  Co., 
Aquae  font.,       .      aa.  f.  5  ij. 
Fiat  mistura,  cujus  sumatur  cochl.  parv.  mane 
ac  nocte. 

In  chronic  bronchitis,  whether  idiopathic,  or  con-- 
sequent  upon  follicular  disease,  we  have  derived 
great  advantage  from  the  use  of  the  subjoined  pre- 
paration : 


62  EXCITANTS   AND   ALTERATIVES. 

57. 

!^  Decoc.  Polygalae,      S  v. 
Potass.  lodid.,     .      5  iij. 
Tr.  Opii  Camphor.,  f.  S  j. 
Syrupi  Tolutan.,       f.  S  ij. 
Fiat  mistura.     Capiat  cochleare  parvum  bis  in 
die. 

Although  the  constitutional  effects  of  Iodide  of 
Potassium  are  very  analogous  to  those  of  Iodine, 
yet  it  may  be  given  in  larger  doses,  and  for  a  longer 
period,  without  producing  disorder  of  the  system, 
than  the  free  Iodine.  When  indications  of  a  scro- 
fulous diathesis  are  present,  in  any  case,  it  will  be 
preferable,  and  wiU  prove  more  efficacious,  to  exhi- 
bit the  two  preparations  in  combination  : 

58. 

]^  lodini  purge,       .     gr.  vj. 
Potass.  lodid.,         5  iss. 
Tinct.  Cardamom.,  f.  S  i. 
Syr.  Sarsa.  Co.,       f  S  iij. 
Fiat  mistura.     Exhibe  cochl.  parv.  bis  terve  in 
die. 

In  the  treatment  of  asthma,  particularly  when 
this  disease  is  consequent  upon,  or  is  complicated 
with,  bronchial  inflammation,  we  have  found  the 
Iodide  of  Potassium,  conjoined  with  the  use   of 


EXCITANTS    AND    ALTERATIVES.  63 

Lobelia,  and  Decoc.  Polygalo3  prove  greatly  bene- 
ficial. 

59. 

1^  Potass.  lodid.,     .     .     5  ij. 
Decoc.  PolygalaB,     .     5  iv. 
Tinct.  Lobelia9, 
Tinct.  Opii  Camphor,,  aa.  Sj. 
Fiat  mist,  capiat  cochl.  parv.  bis  terve  in  die. 

The  Iodides,  which  are  formed  by  the  combina- 
tion of  Iodine  and  Mercury,  are  valuable  medicinal 
agents. 

The  Protiodide  of  Mercury,  and  the  Biniodide 
are  the  preparations  ordinarily  used  in  the  treat- 
ment of  disease.  But  for  several  years  we  have 
been  accustomed  to  use  a  combination  of  the  Pro- 
tiodide of  Mercury,  with  the  Iodide  of  Potassium, 
by  which  combination  a  double  salt,  a  Hydrargyro- 
lodide  of  Potassium  is  formed,  a  remedy  which,  in 
our  experience,  has  proved  altogether  the  best 
alterative  we  have  ever  employed  : 

60. 

^  Protiodid.  Hydrarg.,       gr.  iij. 
Potass.  lodid.,       .     .      5  ij. 
Tinct.  Rhei,      .     .     .      f  S  j. 
Syr.  Sarsa.  Co.,     .     .      f.  S  iij. 
Fiat  mistura,  et  date  cochl.  parv.  bis  in  die. 


64  EXCITANTS   AND   ALTERATIVES. 

We  desire  to  call  particular  attention  to  this 
compound,  because  of  the  striking  advantages  we 
have  obtained  from  its  use  in  the  treatment  of  dis- 
ease. Administered  in  the  early  stage  of  tubercu- 
losis, or  in  cases  of  obstinate  and  long-continued 
follicular  laryngitis,  with  ulcerations  of  the  epiglot- 
tis, or  within  the  larynx,  this  medicine,  as  a  gene- 
ral remedy,  has  proved  more  efficient,  in  our  expe- 
rience, than  any  other  single  agent  in  the  Materia 
Medica.  In  secondary,  or  constitutional  syphilis, 
it  win  be  found  an  invaluable  remedy.  Under  its 
administration,  the  syphilitic,  ulcerated  throat  will 
quickly  assume  a  more  healthy  appearance  ;  and. 
ordinarily,  will  heal  rapidly,  when  appropriate 
topical  measures  are  conjoined.  We  generally 
commence  the  treatment  of  such  cases,  by  adminis- 
tering the  following  combinations : 

61. 

"Bji  Potass.  lodid.,      .     .      5  ij. 
Protiodid.  Hydrarg.,       gr.  ijss. 
Tinct.  Grentianaa, 

Syr.  Sarsa.  Co.,     .     .      aa.  f.  5  ij. 
M.  Sumatur  cochl.  parv.  bis  terve  in  die. 

The  apothecary  will  sometimes  object  to  the 
above  combinations,  because  a  decomposition  is 
effected — the   Protiodide  of  Mercury  being  con- 


EXCITANTS   AND    ALTERATIVES.  65 

verted,  by  the  Iodide  of  Potassium,  into  the  Bin- 
iodide,  and  Metallic  Mercury.  But  it  is  well  known 
to  chemists,  that  these  different  Iodides  will  unite 
together  in  different  proportions,  by  which  those 
compounds,  which  Berzelius  terms  double  Iodides, 
are  formed.  The  Biniodide  thus  formed  in  the 
above  solution,  immediately  unites  with  a  portion 
of  the  Iodide  of  Potassium,  in  solution,  and  a  dou- 
ble salt — the  Hydrargyro-Iodide  of  Potassium — is 
the  result. 

Our  experience  in  the  employment  of  this  thera- 
peutic agent  has  been  extensive,  and  we  have  found 
it  more  efficacious  in  the  treatment  of  disease,  in  a 
fourfold  degree,  than  the  use  of  either  the  Prot- 
iodide  or  the  Biniodide  alone. 

Not  only  in  the  preceding  diseases — severe  folli- 
culitis, and  secondary,  or  constitutional  disease — 
has  this  combination  of  the  Iodides,  the  Hydrar- 
gyro-Iodide  of  Potassium,  been  found  useful,  but 
its  administration  in  many  obstinate  cutaneous 
affections  has  proved,  in  our  hands,  to  be  highly 
advantageous. 

62. 

^  Extract.  Conii,     .     .      5  iss. 
Proto-Iodid.  Hydrarg.,  gr.  iv. 
Potassse  lodidi,    .     .      5  iij. 
Tinct.  Cardamom.,    .      f.  S  ij. 
Syr.  Sarsa.  Co.,    .     .     f  5  iv. 
5 


66  EXCITANTS   AND    ALTERATIVES. 

Fiat  mistura.     Capiat  cochl.  parv.  bis  terve  in 
die. 


This  preparation,  administered  as  above,  may  be 
employed  in  the  treatment  of  lupus,  lepra,  and 
other  obstinate  cutaneous  afifections,  especially  those 
of  a  scaly  character,  with  safety  and  advantage. 

With  my  colleague.  Prof.  J.  M.  Carnochan,  sur- 
geon-in-chief to  the  State  Hospital,  Donovan's 
solution — which  is  a  combination  of  Iodine,  Arsen- 
ic, and  Mercury — is  a  favorite  remedy  in  the  treat- 
ment of  lupus,  venereal  eruptions,  impetigo,  and 
other  chronic  cutaneous  diseases. 


63. 


^  Liquor  Arsenici  et  Hydrarg.  lodid.,   S  ss. 

Syr.  Sarsa.  Co., S  viij. 

M.  Sumat  cochl.  una  parv.  ter  quotidie. 


In  laryngeal  and  bronchial  disease,  and  also  in 
the  early  stage  of  phthisis,  when  any  degree  of  fe- 
brile action  is  present,  the  Iodide  of  Potassium,  in 
combination  with  Antimony,  will  frequently  prove 
more  useful  than  when  administered  alone. 


EXCITANTS   AND    ALTERATIVES.  67 

64. 

lEji  Potass.  lodidi,     ...      5  ij. 
Antimon.  et  Potass.  Tart.,  gr.  ij. 
Syr.  Zingib., 

Aquae  font.,         .     .     .      aa.  f.  5  iij. 
Fiat  mistura  cujus  sumat.  cochl.  parv.  bis  in  die. 

Or  we  may,  under  the  same  circumstances,  exhi- 
bit the  following  : 

65. 

1^  Potass.  lodidi,   5  iiss. 
Syr.  Ipecac,      f.  S  ij. 
Aquae  font.,       f.  S  iv. 
M.  Capiat  cochl.  parv.  bis  terve  in  die. 

A  combination  of  the  medicinal  Hydrocyanic 
Acid,  with  a  solution  of  Iodide  of  Potassium,  con- 
stitutes a  favorite  remedy  with  some  practitioners 
in  the  treatment  of  phthisis. 

66. 

^i  Potass.  lodidi,      .     5  ij. 
Acidi  Hydrocyanici,  gtt.  xl. 
Syr.  Sarsa.  Comp., 
Aquae  font.,      .     .     aa.  f.  S  ij. 
Fiat  mist.     Sumatur  cochl.  min.  mane  ac  nocte. 


68  EXCITANTS   AND    ALTERATIVES. 

Although,  as  we  have  stated,  the  Iodide  of 
Potassium  is  a  better  preparation  for  administra- 
tion than  the  Iodine  in  most  forms  of  disease  ;  yet, 
when  indications  of  a  scrofulous  diathesis  are 
present,  especially  in  young  persons  and  children, 
it  will  be  preferable,  and  will  frequently  prove 
more  efficacious,  to  exhibit  the  two  preparations 
in  combination. 

67. 

^i  lodini,       .     .     gr.  x. 
Potass.  lodid.,    5  j. 
Syr.  Rhei, 

Aquae  purge,       aa.  f  S  ij. 
Fiat  mistura,  date  cochl.  par  v.  ter  in  die. 

Few  remedies  will  be  found  more  efficacious  for 
promoting  the  absorption  of  glandular  swellings  in 
the  neck,  or  of  those  in  other  parts  of  the  body, 
than  the  following  preparation  : 

68. 

^  lodini,       .     .     gr.  x. 
Potass.  lodid.,     5  j. 
Liquor.  Potass.,  f.  S  j. 
Syr.  Sarsa.,     .     f.  S  iij. 
Fiat  solutio.     Capiat  cochl.  parvum  bis  in  die. 


EXCITANTS   AND  ALTERATIVES.  69 

In  the  treatment  of  hypertrophy  of  the  heart, 
and  in  other  diseases  of  this  organ,  when  it  is 
important  to  reduce  vascular  action,  the  subjoined 
mixture  may  be  advantageously  exhibited  : 

69. 

^  Potass.  lodidi,     .    5  iiss 
Tinct.  Hyoscyami, 
Tinct.  Digitahs,   .   aa.  f  S  ss. 
Syr.  Sarsa.  Co.,   .   f.  S  v. 
Fiat  mistura,  date  cochl.  min.  mane  ac  nocte. 

The  combining  of  Iodine  and  Iron  was  first 
practised  by  Dr.  Pierquin,  and  the  product  of  this 
combination — the  Iodide  of  Iron — was  employed 
by  him  for  the  treatment  of  disease,  in  1824, 
although  the  credit  of  first  introducing  the  remedy 
into  medical  practice  is  attributed  to  Dr.  Thomp- 
son, of  London. 

The  Iodide  of  Iron  is  a  valuable  therapeutic 
agent.  In  its  operation  on  the  system  it  is  con- 
sidered to  be  more  nearly  allied  to  the  prepara- 
tions of  Iron  than  to  those  of  Iodine.  In  scrofu- 
lous debility,  in  strumous  enlargements  of  the 
glandular  system,  in  chlorosis,  and  amenorrhoea, 
and  in  most  affections,  where  ferruginous  prepara- 
tions are  indicated,  the  Iodide  of  Iron  has  been 
found   especially  useful.     It  is  most  frequently 


70  EXCITANTS   AND    ALTERATIVES. 

administered  in  the  form  of  a  syrup.  Syrup  of 
the  Iodide  of  Iron  may  be  used  as  a  tonic  in  doses 
of  from  XV.  to  xxv.  drops,  twice  daily,  in  the  treat- 
ment of  any  of  the  preceding  diseases. 

Several  years  ago.  Dr.  Dupasquier,  of  Lyons, 
published  some  interesting  statements  in  regard 
to  the  favorable  effects  of  the  Protiodide  of  Iron 
in  the  treatment  of  pulmonary  phthisis.  An  emi- 
nent physician  of  New  Orleans,  who  has  had  much 
experience  in  the  treatment  of  thoracic  disease, 
strongly  recommends  in  phthisis,  chronic  bron- 
chitis, etc.,  the  following  combination  : 

YO. 

'^i  Syr.  Ferri  lodidi,  5  vi. 

Potass.  lodidi,    .  gr.  xii. 
Glycerinse  Pur., 

Syrupi  Limonis,  aa.  f.  S  j. 

AqujB  font.,         .  f.  S  iv. 
Fiat  mistura,  cujus  capiat  cochl.  ampl.  ter  in  die, 
ante  cibum. 

It  is  highly  desirable  that  so  important  a  thera- 
peutic agent  as  the  Iodide  of  Potassium  should  be 
of  such  a  degree  of  purity  as  not  to  affect  its  medi- 
cal use.  But,  unfortunately,  not  only  impurities, 
but  adulterations  of  the  commercial  article  are 
often  found  to  exist.     It  is  frequently  found  adul- 


EXCITANTS    AND    ALTERATIVES.  71 

terated  with  Carbonate  of  Potassa,  with  the  Chlo- 
ride of  Sodium,  and  when  not  prepared  with  care, 
will  often  contain  the  lodate  of  Potassa.  Some 
test,  therefore,  which  will  enable  us  to  detect  these 
adulterations  easily  and  with  certainty,  is  quite 
desirable.  When  adulterated  with  Carbonate  of 
Potassa,  it  may  readily  be  detected  by  dissolving 
the  suspected  article  in  alcohol.  Iodide  of  Potas- 
sium which  contains  no  water  of  crystaUization,  is 
freely  dissolved  by  alcohol ;  but  the  Carbonate  of 
Potash  will  not  dissolve.  A  very  simple  and  cer- 
tain test  is  given  in  a  late  number  of  the  London 
Pharmaceutical  Journal,  to  detect  the  presence  of 
either  Carbonate  or  lodate  of  Potash.  This  is  the 
s7/rup  of  the  Iodide  of  Iron.  To  a  small  amount  of 
the  Iodide  of  Potassium  in  solution,  add  a  drop  or 
two  of  the  syrup  of  Iodide  of  Iron.  If  pure,  no 
change  will  be  produced  ;  but  if  Carbonate  of 
Potash  be  present,  a  pale  blue  precipitate  is  formed 
at  once.  If  the  specimen  contain  lodate  of  Potassa, 
a  red  precipitate  occurs  immediately.  If  both  Car- 
bonate and  lodate  of  Potash  are  present,  on  adding 
the  test,  first  a  deeper  blue,  and  then  a  red  precipi- 
tate will  be  found.  If  the  usual  precautions,  as  to 
equal  quantities,  etc.,  are  observed,  with  the  sam- 
ples examined,  the  resultant  precipitates  will  show 
the  relative  amount  of  the  adulterating  agents  in 
each.     We  have  used  this  test  frequently  in  exam- 


72  EXCITANTS   AND   ALTERATIVES. 

ining  different  preparations  of  the  Iodide  of  Potas- 
sium, and  have  found  it  efficient  in  detecting  their 
presence,  when  these  adulterations  have  existed. 

We  have  spoken  of  the  valuable  properties  of 
the  Protiodide  of  Mercury,  especially  when  this 
salt  is  administered  with  the  Iodide  of  Potassium. 
There  are  several  other  salts,  the  product  of  Iron 
and  its  combinations,  which  are  medicinal  agents  of 
great  value.  The  therapeutic  action  of  these  com- 
pounds is  various.  The  Iodide  of  Iron  acts  as  a 
tonic ;  the  Iodide  of  Mercury,  as  we  have  stated, 
operates  as  an  alterative ;  the  Iodide  of  Arsenic,  as 
an  excitant  and  tonic ;  the  Iodide  of  Lead,  as  a 
diuretic;  and  the  Iodide  of  Sulphur  acts  most 
decidedly  on  the  skin. 

n. 

"S^  Arsenici  lodidi,  gr.  iij. 
Extract.  Conii,    5  ss. 
M.  Fiant  pilulae  xxx.  quarum  sumatur  una  ter 
in  die. 

This  medicine,  after  many  other  remedies  have 
failed,  has  been  employed  with  great  success,  in 
the  treatment  of  some  most  inveterate  cases  of 
certain  chronic  cutaneous  disease  ;  particularly 
lepra,  psoriasis,  and  venereal  eruptions.  The  dose 
may  be  cautiously  increased  to  the  one-fifth  of  a 


EXCITANTS   AND    ALTERATIVES.  73 

grain,  three  times  a  day.  When  gastric  disorder 
supervenes,  the  medicine  should  be  for  a  time  sus- 
pended, and  be  subsequently  renewed  in  the  origi- 
nal dose. 

Some  practitioners  in  this  country  employ,  with 
success,  in  the  same  affections,  a  combination  of  a 
solution  of  the  Arsenite  of  Potash,  and  of  the  com- 
pound solution  of  Iodine  ;  as  in  the  following 
extemporaneous  preparation  : 

72. 

Liquor.  Potassae  Arsenitis,    .     f  S  ij. 
Liquor.  lodidi  Potassii  Comp.,  f.  S  ss. 
.iat  mist,  cujus  cap.  gtt.  v.  ter  in  die. 

Both  of  the  above  preparations  of  Iodine  and 
Arsenic  are  employed  with  great  advantage  in  the 
treatment  of  cancerous  affections,  particularly  when 
these  remedies  are  conjoined  with  the  use  of  the 
following  ointment  of  the  Iodide  of  Lead,  employed 
as  an  external  apphcation  : 

73. 

]^  Plumbi  lodidi,   5  ij. 
AxungioB,      .      S  ij. 
Misce  intim. 

A  small  amount  of  this  ointment  may  be  rubbed 


74  EXCITANTS    A.ND    ALTERATIVES. 

in,  twice  a  day,  over  cancerous,  or  other  indolent 
tumors. 

Under  the  head  of  Tonics  and  Stimulants,  we  have 
spoken  of  the  therapeutic  value  of  the  Iodide  of 
Manganese  in  the  treatment  of  cancerous  affections, 
glandular  enlargements,  and  some  other  obstinate 
diseases.  We  have  had  prepared  by  an  excellent 
apothecary  of  this  city,  after  the  formula  of  Proc- 
tor, a  syrup  of  the  Iodide  of  Manganese,  which,  as 
an  excitant  and  alterative,  is  superior  to  the  syrup 
of  the  Iodide  of  Iron,  in  the  treatment  of  many 
diseases.  This  medicine — the  syrup  of  the  Iodide 
of  Manganese — may  be  readily  prepared  in  the  fol- 
lowing way  : 

74. 

'Bf  Manganesii  Sulph.,   5  xvj. 
Potass.  lodidi,     .      5  xix. 

Dissolve  the  Manganese  and  the  Potassium  sepa- 
rately, each  in  three  fluid  ounces  of  water,  to  which 
are  added  two  fluid  drachms  of  S3T:up.  When  the 
precipitation  of  the  crystals  of  Sulphate  of  Potassa, 
which  will  follow,  is  completed,  filter  the  super- 
natant hquor  through  a  fine  mushn  into  a  vessel 
containing  twelve  ounces  of  pulverized  sugar.  Then 
add  to  this,  water  sufficient  to  make  the  whole 
amount  to  ons  pint.     Shake  until  the  sugar  is  well 


EXCITANTS  AND   ALTERATIVES.  75 

dissolved,  and  keef  the  syrup  in  a  glass-stopped 
bottle.  In  tuberculosis,  in  scrofulous  and  cance- 
rous affections,  in  the  treatment  of  glandular  en- 
largements, such  as  those  of  the  spleen  and  of  the 
neck,  and  in  constitutional  syphilis,  the  syrup  of 
the  Iodide  of  Manganese,  administered  in  doses  of 
from  ten  to  twenty  drops,  twice  or  thrice  a  day, 
will  be  found  to  be  a  valuable  remedial  agent. 

As  alterative  remedies,  the  preparations  of  Mer- 
cury are  more  employed  by  practitioners,  than  any 
of  the  other  inorganic  agents.  Administered  in 
small  doses,  the  £i- Chloride  of  Mercury  is  a  valua- 
ble excitant.  Its  effects  are  more  decidedly  altera- 
tive, says  Nehgan,  than  those  of  any  other  prepara- 
tion of  the  metal.  In  cases  of  chronic  follicular 
disease,  where  the  symptoms  indicate  the  presence 
of  a  thickening  of  the  mucous  membrane  of  the 
larynx,  and  in  the  early  stage  of  some  forms  of 
pulmonic  disease,  we  have  found  the  Bi-Chloride 
of  Mercury  a  most  efficient  alterative,  and  alto- 
gether one  of  the  best  therapeutic  preparations  of 
this  mineral. 

75. 

^  Hydrarg.  Chlorid.  Corrosiv.,  gr.  iv. 
Extract.  Conii,     .     .     .     .     9  ij. 
Fiat  massa  in  pilulas  xl.  divide.     Sumat  unam, 
mane  et  nocte. 


76  EXCITANTS   AND    ALTERATIVES. 

An  experienced  practitioner  aflfirms  that  in 
hepatization  of  the  lungs,  the  sohd  matter  depo- 
sited in  the  air-cells  is  often  absorbed  and  the  cells 
rendered  permeable  to  air  by  the  use  of  this  prepa- 
ration. In  irritable  subjects,  opiates  should  be 
conjoined  with  this  remedy,  as  the  mucous  mem- 
brane of  the  stomach  and  bowels  is  sometimes  irri- 
tated by  its  use. 

76. 

'^i  Hydrarg.  Chlorid.  Corrosiv.,  gr.  iv. 
Extract.  Opii,      .     .     .     .     gr.  x. 
Extract.  Gentian.,    ...     9  ij. 
M.  Fiant  pilulsB  xl.   quarum   sumatur  una   bis 
j^erve  in  die. 

This  preparation  has  also  been  highly  extolled 
in  secondary  venereal  affections,  in  chronic  cuta- 
neous diseases — particularly  those  which  are  at- 
tended with  dry,  scaly  eruptions — and  in  chronic 
rheumatism  and  arthritis.  The  following  is  the 
formula  of  Dzondi,  of  Halle,  who  is  a  great  advo- 
cate for  the  use  of  the  Bi-Chloride  of  Mercury  : 

77. 

^  Hydrarg.  Chlorid.  Corrosiv.,  gr.  xii. 
Solve  in  Aq.  distil,  q.  s. 
Adde  micse  Panis  Albi, 
Saccharis  albi  aa.  q.  s.  ut  fit  pilulae  numero  ccxl. 


EXCITANTS    AND    ALTERATIVES.  77 

Of  these  pills — each  of  which  contains  the  twen- 
tieth of  a  grain  of  the  Mercury — two  may  be  given 
night  and  morning. 

In  many  of  the  above  chronic  forms  of  disease, 
this  medicine  is  advantageously  administered,  con- 
joined with  a  vegetable  bitter  tonic  : 

78. 

1^  Hydrarg.  Chlorid.  Corrosiv.,  gr.  iv. 
Tinct.  Gentianae,      .     .     .     S  iv. 
Syr.  Aurantii,      .     .     .     .     S  ij. 
Fiat  mistura,    cujus    date    cochl.   parv.   ter  in 
die. 

As  an  excitant  and  an  alterative,  in  many  of  the 
diseases  in  childhood,  the  Hydrargyrum  cum  Greta 
has  been  more  universally  employed  than  any  of 
the  other  preparations  of  this  mineral.  It  is,  how- 
ever, hke  the  blue  mass,  not  always  a  perfect  pre- 
paration, as  it  consists  of  MetaUic  Mercury  in  a 
state  of  minute  division,  mechanically  combined 
with  the  Sub-oxide  of  Mercury,  and  the  Garbonate 
of  Lime.  But  it  has  not  been  ascertained  in  what 
proportions  the  metal  and  the  oxide  exist. 

As  a  gentle  and  more  certain  laxative  and  altera- 
tive, and  one  equally  well  adapted  for  infancy  and 
childhood,  some   eminent   American  practitioners 


78  EXCITANTS   AND    ALTERATIVES. 

prefer,  altogether,  the  Chloride  of  Mercunj  minutely 
subdivided  by  being  thoroughly  triturated  with  a 
large  amount  of  sugar. 

To  one  part  of  Calomel  add  ten  parts,  by  weight, 
of  white  sugar. 

79. 

^  Hydrarg,  Chlorid.  Mitis,   5  j. 
Sachari  Alb.,      ...      5  x. 

Triturate  the  two  substances  in  a  wedgewood 
mortar  for  ten  or  fifteen  minutes,  so  as  to  subdivide 
minutely,  and  intimately  to  blend  the  Calomel  and 
the  Sugar. 

Those  who  have  never  tried  the  Mercury  thus 
prepared,  will  be  surprised  at  the  increased  activity 
which  will  be  imparted  to  the  medicine,  by  this 
fine  subdivision  of  its  particles.  Indeed,  it  is  to 
this  well-estabhshed  fact,  that  many  medicines 
become  much  more  active  by  minute  subdivision, 
that  the  whole  secret  of  the  Hahnemannic  "  po- 
tency," or  dynamization  of  remedies,  may  be 
referred.* 

*  The  editors  of  the  "  British  Journal  of  Homoeopathy,"  admit,  in  a  late 
number  of  this  Journal,  "  the  theory  of  dynamization  to  be  untenable,  and 
that  it  is  now  rejected  by  the  great  majority  of  Hahnemann's  disciples." — 
Journal  of  Homoeopathy^  July^  1852. 


EXCITANTS   AND    ALTERATIVES.  79 

Fh'e  grains  of  the  above  preparation  will  con- 
tain half  a  grain  of  Calomel,  and  this  small  amount, 
taken  on  going  to  bed,  will  produce,  with  most 
persons,  a  mild  laxative  effect  the  following  day. 
With  young  children,  half  this  amount,  or  from 
two  to  three  grains  of  the  medicine  placed  on  the 
tongue  (and  children  take  it  as  readily  as  they  will 
pure  sugar),  will  be  sufficient,  ordinarily,  to  prove 
cathartic. 

A  physician  of  this  State,  of  large  experience, 
who  practises  in  a  region  of  the  country  where 
dysentery  prevails  as  an  endemic  almost  annually, 
assures  us  that  this  preparation  of  Calomel  is  his 
favorite  and  most  efficient  remedy  in  the  treatment 
of  dysentery  in  children.  He  administers  one  grain 
of  the  powder,  once  in  four  or  six  hours  ;  employ- 
ing, at  the  same  time,  injections  of  a  solution  of 
Morphia,  to  control  the  dysenteric  discharges. 
With  this  plan  of  treatment  he  has  succeeded,  he 
affirms,  in  arresting  the  disease  more  frequently 
than  with  any  other  method. 

More  than  twenty  years  ago,  we  were  instructed 
by  our  preceptor — who  has  sioce  been  a  distin- 
guished lecturer  and  writer  on  Materia  Medica — 
to  employ  the  following  combination,  as  our  "  offi- 
cinal "  preparation  of  Calomel : 


80  EXCITANTS    AND    ALTERATIVES. 

80. 

!l^  Hydrargyri  Chloridi  Mitis,   5  ij. 
Extract.  Opii, 

Ipecac.  Pulv.,    .     .     .     .     aa.  gr.  vj. 
Pulverize,  and  mix  intimately  and  thoroughly, 
as  in  the  preceding  combination. 

Thus  prepared,  every  scruple  of  Calomel  will 
contain  one  grain  each  of  Opium  and  Ipecacuanha, 
intimately  combined  with  the  mineral. 

During  a  period  of  twenty  years,  we  have  used 
no  other  preparation  of  Calomel  than  the  above  in 
our  practice.  We  have  recommended  its  employ- 
ment in  our  lectures  to  the  students  and  graduates 
of  the  N.  Y.  Medical  College,  and  to  many  physi- 
cians, who  have  adopted  its  use  ;  and  we  venture 
the  assertion,  that  no  practitioner,  after  having 
once  employed  this  combination,  will  prefer,  after- 
wards, to  prescribe  pure  Calomel  in  the  treatment 
of  disease.  Under  all  circiunstances,  a  given 
amount  of  this  combination,  whether  administered 
as  a  laxative  or  as  an  alterative,  will  prove  fuUy  as 
efficient  as  double  the  amount  of  pure  or  uncom- 
bined  Calomel ;  and  without  producing — ^whether 
given  to  children  or  adults — at  all  that  degree  of 
irritation  which  ordinarily  follows  the  administra- 
tion of  the  latter.     As  a  laxative,  from  three  to 


EXCITANTS    AND    ALTERATIVES.  81 

five  grains  may  be  administered  to  an  adult,  and 
from  one  and  a  half  to  three  grains  to  children. 

Besides  the  excitants  and  alteratives,  which  are 
obtained  from  inorganic  substances,  there  are  some 
important  therapeutic  agents  of  this  kind  belonging 
to  the  organic  or  vegetable  kingdom,  which  are  of 
much  value. 

The  extract  of  Podophyllum,  or  May-apple,  is 
much  used  as  a  remedial  agent  by  physicians  in 
some  parts  of  this  country  j  and  when  the  remedial 
value  of  the  preparations  of  this  plant  are  better 
known,  they  will  be  still  more  extensively  em- 
ployed by  the  profession. 


81. 

^  Extracti  Podophj-lli,    .  5  j. 

Extract.  Aloes  Hepat.,  5  iij. 

Gambogiae,    .     .     .     .  Sj. 
M.  Fiat  pilulae  Ix. 

The  above  constitutes  excellent  alterative  and 
cathartic  pills,  and  may  be  administered  with  great 
advantage  in  cases  of  hepatic  derangement,  in  ana- 
sarca, and  in  all  glandular  diseases. 

The  following  is  the  favorite  cathartic  pill  of  an 
eminent  practitioner  ot"  Connecticut : 

6 


82  EXCITANTS    AND    ALTERATIVES. 

82. 

!^  Extract!  Podophylli,     .     5  ij. 
Hydrarg.  Chlorid.  ]\l.itis,   5  j. 
Olei  Cajuputi,      .     .     .    gtt.  vj. 
M.  Fiat  massa,  in  pilulas  Ix.  div. 

Instead  of  the  extract  we  have  recently  employed 
the  Podophyllin,  which  is  the  active  principle  of  the 
plant,  obtained  from  its  root,  and  which,  from  the 
commendation  of  several  of  our  professional  friends 
and  from  the  trial  we  have  ourselves  made,  we  are 
confident  will  prove  to  be  an  addilion  to  our  Mate- 
ria Medica  of  great  value. 

Judiciously  administered,  it  is  a  superior  exci- 
tant and  alterative,  and  in  appropriate  doses,  a  cer- 
tain and  safe  cathartic.  Care  should  be  taken  not 
to  prescribe  this  remedy  in  too  large  doses,  as  it  is 
apt  to  produce  griping  and  nausea  when  thus 
administered.  This,  however,  is  said  to  be  effect- 
ually prevented  by  combining  the  medicine  with  a 
diffusible  stimulant. 

83. 

!^  Podophyhin,   .     gr.  xv. 
Zinziberis  Pulv.,  5  ss. 
Ext.  Gentiange,    5  ss. 
M.  Fia^  Mass.  et  in  pilulas  xxx.  div. 


EXCIT.4NTS    AND    ALTERATIVES.  83 

These  pills  may  be  administered  in  all  cases  in 
which  the  blue  mass  or  other  mild  mercurials  are 
given.  This  remedy  has  been  highly  recommended 
in  cases  of  secondary  syphilis,  when  Mercury  has 
been  long-continued,  or  is  from  any  cause  inadmis- 
sible. Administered  in  a  full  cathartic  dose,  it  is 
declared  to  have  been  eminently  successful  in  the 
expulsion  of  ascarides  ;  and,  also,  when  thus  ad- 
ministered and  followed  in  four  or  six  hours  with 
a  full  draught  of  Olive  Oil  to  the  amount  of  four 
or  six  omices,  Podophylhn  has  proved  successful, 
it  is  said,  in  many  instances,  in  the  dislodgement 
and  expulsion  of  large  quantities  of  biliary  calcuh^ 
with  very  little  pain.  Triturated  with  sugar  in  the 
same  manner  as  we  have  recommended  Calomel  to 
be  prepared,  Podophyllin  is  a  most  excellent  laxa- 
tive and  alterative. 

84. 

^  Podophyllin,  .    5j. 
Sacchari  Albi,     5  xix. 

Mix  and  triturate  until  the  two  be  finely  sub- 
divided and  thoroughly  blended.  As  a  mild  laxa- 
tive and  alterative,  this  powder  may  be  exhibited 
in  doses  of  from  five  to  ten  grains.  The  medicine 
may  be  given  in  all  cases  where  mercurials  are 
indicated. 


84  EXCITANTS    AND    ALTERATIVES. 

Among  the  remedies  obtained  from  the  organic 
or  vegetable  kingdom,  are  several  therapeutic 
agents  that  are  not  found  in  many  foreign  pharma- 
copoeias, but  which  are  much  employed,  and  are 
held  in  high  estimation  by  many  American  prac- 
titioners. Among  these  may  be  mentioned  the 
Sanguinaria  Canadensis,  the  Actcea  Racemosa,  or 
Cimicifuga  Racemosa,  as  this  plant  is  named  by 
some  botanists  ;  and  the  Veratrum  Viride,  or 
American  Hellebore. 

The  Sanguinaria,  or  Bloodroot,  has  been  long 
employed  as  an  excitant  and  alterative,  and  is  a 
favorite  remedy  with  many  practitioners  in  New 
England,  and  in  the  Western  States.  It  is  ordina- 
rily administered  in  the  form  of  tincture  ;  but  the 
officinal  preparation  of  our  pharmacopoeias  (four 
ounces  of  the  root  in  two  pints  of  diluted  alcohol), 
is  nearly  an  inert  preparation  ;  and,  as  this  is  the 
strength  of  the  tincture  ordinarily  kept  and  dis- 
pensed by  our  apothecaries,  we  have  long  been  of 
the  opinion,  that  the  disappointment  in  the  effects 
of  this  remedy,  which  has  occurred  to  many  prac- 
titioners, has  arisen  altogether  from  the  fact,  that 
they  have  prescribed  a  preparation  too  weak  to  be 
efficient.  We  have  used  the  Sanguinaria  in  the 
treatment  of  disease,  during  a  period  of  many  years, 
but  we  have  always  employed  the  saturated  tinC' 
fure  (four  ounces  of  the  bruised  root  macerated  in 


EXCITANTS   AND    ALTERATIVES.  86 

one  pint  of  diluted  alcohol),  and  we  can  speak  with 
much  confidence,  with  regard  to  its  valuable  thera- 
peutic properties. 

The  following  combination  of  the  bloodroot,  with 
the  compound  Tincture  of  Aloes,  is  employed  by 
some  experienced  practitioners  in  Ohio,  in  the 
treatment  of  a  torpid  condition  of  the  bowels, 
arising  from  a  derangement  of  the  hejoatic  organs, 
and  is  esteemed  an  excellent  eccoprotic  : 

85. 

^  Tinct.  Sanguinariae  Sat. 

Tinct.  Aloes  Comp.  p.  ge. 
Fiat  mistura. 

Trom  30  to  60  drops  of  this  preparation  may  be 
administered  twice,  daily.  It  tends  to  improve  the 
digestive  organs,  and  to  increase  the  peristaltic 
action. 

86. 

]^  Tinct.  Sanguinarioe  Sat. 
Vini  IpecacuanhaB,  p.  ge. 
To  which,  in  some  instances,  a  little  laudanum  is 
added. 

The  above  combination  is  employed  by  many 
Western  practitioners,  in  the  treatment  of  fevers, 
and  is  considered  by  them  a  most  excellent  fehri- 


86  EXCITANTS    AND    ALTERATIVES. 

fuge.  But,  it  is  in  the  treatment  of  some  forms  of 
cough,  dependent  upon  bronchial  or  pulmonary 
irritation,  that  we  have  found  the  saturated  tinc- 
ture of  Sanguinaria  to  be  a  remedy  of  the  highest 
excellence.'''' 

87. 

!^  Tinct.  SanguinarijB,    5j. 
Tinct.  Opii,       .     .     5  ij. 
Vini  Ipecacuanhoe,      5  vj. 
Syr.  Tolutan.,  .     .     S  ij. 
Fiat  mistura,  quarum  capiat  M.  xxx.  usque  ad 
Ix.  quater  in  die. 

In  catarrhal  affections,  and  in  cases  of  trouble- 
some cough  following  influenza,  the  above  prepara- 
tion may  be  given  with  much  advantage. 

We  have  employed  the  preceding  mixture  for 
many  years,  to  mitigate  the  cough  in  the  early  and 
in  the  advanced  stage  of  phthisis. 

*  The  following  is  the  original  formula  for  the  preparation  of  "  Ajer's 
Cherry  Pectoral :" 


^  Morph.  Acetat gr.  iij. 

Tinct.  Sanguin.  Canaden.,  3  ij. 
Vini  Antim.  et  Potass,  tart., 

Vini  Ipecacuanhse,    .     .     .  aa.  3  i\J> 

Syrupi  Pruni  Virgin.,     .     .  §  iij. 

M. 


EXCITANTS   AND    ALTERATIVES.  87 

Should  the  cough  be  dry,  or  much  inflammatory 
action  be  present,  antimonial  wine  may  be  substi- 
tuted for  the  syrup  of  Ipecac,  and  less  of  the  ano- 
dyne be  added,  as  in  the  following  : 


89. 


^  Tinct.  Sanguinarise, 

sj- 

Morph.  Sulph.,     . 

gr.  iss. 

Tinct.  Digitalis, 

Yini  Antimo., 

aa.   S  ss. 

01.  Gaultherise,    . 

gtt.  X. 

Misce. 

This  may  be  admuiistered,  as  above,  in  doses  of 
from  20  to  40  drops  twice  or  thrice,  daily. 

We  are  assured  by  an  old  and  experienced  phy- 
sician of  this  State,  that  he  has  succeeded  in  over- 
coming habitual  constipation  more  frequently  with 
the  following  pill,  than  with  any  other  laxative  : 

90. 

^  Sanguinariae  Pulveris, 

Rhei  Pulveris,     .     .     aa.  5  j. 
Saponis,     ....      9ij. 
Misce.  et  cum  aqua3  fiat  mass,  in  pilulas  xxxii. 
dividenda,  quarum  capiat  una  mane  ac  nocte. 


88  EXCITANTS   AND    ALTELATINES. 

The  Actcsa  Racemosa,  or  Cimicifuga  Racemosa, 
or  Cohosh,  or  Black  Snakeroot — ^names  by  which 
this  plant  is  sometimes  called — is  a  native  of  the 
United  States  and  of  the  Canadas.  It  has  been 
employed  as  a  popular  remedy  in  this  country,  for 
many  years,  for  the  treatment  of  pulmonary  dis- 
eases, rheumatism,  chorea,  anasarca,  etc.  Early 
in  the  present  century,  a  nostrum,  or  secret  reme- 
dy, which  obtained  great  celebrity  in  many  *of  the 
New  England  States,  on  account  of  its  success  in 
the  treatment  of  rheumatism,  was  composed  prin- 
cipally, as  it  was  subsequently  ascertained,  of  a 
saturated  tincture  of  Actaea  Racemosa. 

We  find  this  remedy  to  be  held  in  high  estima- 
tion by  many  excellent  practitioners  from  different 
parts  of  the  United  States,  for  the  treatment  of  the 
above  named,  and  other  kindred  diseases.  During 
a  period  of  more  than  twenty  years,  we  have  em- 
ployed the  Actsea  as  a  therapeutic  agent,  either 
alone,  or  in  combination  with  other  remedies,  with 
great  advantage. 

It  is  best  administered  in  the  form  of  tincture, 
but  it  may  be  given  in  substance  or  in  decoction. 
The  saturated  tincture  (four  ounces  of  the  root  to 
one  pint  of  alcohol),  should  only  be  employed.  It 
may  be  given  in  doses  of  from  twenty  to  forty 
drops,  repeated  every  two  or  three  hours,  in  the 
treatment  of  acute  rheumatism. 


EXCITANTS   AND    ALTERATIVES.  89 

Its  powers  in  rheumatic  affections,  and  in  ana- 
sarca, are  greatly  increased  by  administering  it  in 
the  following  combination  : 

91. 

'Sji  Tinct.  Actaese  Racemosae,   Sj. 
Potassae  lodid.,    .     .     .      5  ij. 
Syr.  Ipecacuanhae,    .     .      S  j. 
Aqu£e  font.,    ....      S  ij. 
M.  d.  coch.  parv.  bis  terve  in  die. 

In  chronic  bronchial  disease,  and  in  the  early 
stage  of  phthisis,  it  has  been  proved  to  be  an  excel- 
lent and  efficient  remedy,  when  combined  with  an 
anodyne,  and  the  tincture  of  Sanguinaria. 

92. 

!^  Tinct.  Cimicifugse  Racemosse, 

Tinct.  Sanguinariae,  .     .     .     aa.   S  j. 
Morph.  Sulph.,      .     .     .     .     gr.  ij. 

Syr.  Acacias, S  ij. 

Ft.  mistura  exhibe  coch.  parv.  tusse  urgenti. 

In  the  treatment  of  chorea,  the  Cimicifuga  has 
been  extensively  employed  in  the  United  States. 

After  free  purging  for  several  days,  preparatory 
to  its  use,  many  practitioners  depend  altogether 


90  EXCITANTS   AND    ALTERATIVES. 

upon  this  remedy  for  the  cure  of  chorea.     By  some 
it  is  administered  in  the  form  of  decoction. 

93. 

^i  Cimicifugse  Racemosae,   gj. 
AquaB  ferventis,     .     .     Oj. 
M.  Ut  fiat  decoction,  cujus  sumant,  coch.  mag.  ij. 
ter  in  die. 

Other  practitioners  prefer  the  use  of  the  pow- 
dered root,  administering  it  in  doses  of  a  teaspoon- 
ful  three  times  a  day. 

In  the  treatment  of  dropsy,  the  following  is  a 
preferred  prescription,  and  has  been  much  em- 
ployed by  an  experienced  practitioner  in  Massa- 
chusetts : 

94. 

!1^  Tinct.  Cimicifugae  Racemosse,  S  j. 

Tinct.  Myrrhae,      ....  5  vj. 
Tinct.  Opii, 

Tinct.  Capsici,       .     .     .     .  aa.  5j. 

Fiat  mist,  capiat  M.  xxx.  vel  xl.  quater  in 
die. 

The  Veratrum  Viride,  or  American  Hellebore,  is 
found  in  various  parts  of  the  United  States,  and  is, 
also,  a  native  of  the  Canadas.     The  plant  is  known 


EXCITANTS    AND    ALTERATIVES.  91 

in  some  places  as  Swamp  Hellebore,  Indian  Poke, 
etc.,  and  is  found  growing  in  swampy  places,  in 
meadows,  and  along  the  borders  of  water  courses. 
It  belongs  to  the  same  order  of  plants  as  the  Col- 
chicum  Autumnale,  and  was  highly  recommended, 
many  years  ago,  by  Professor  TuUy,  of  New  Haven, 
as  a  substitute  for  Colchicum  in  the  treatment  of 
many  of  those  diseases  for  which  this  latter  reme- 
dy has  been  employed.     Within  the  last  few  years, 
public  attention  has  been  called  especially  to  the 
remedial  powers  of  the  Yeratrum  Yiride,  by  Dr. 
W.    C.   Norwood,    of    South    Carolina,    who    has 
devoted  much  time  and  careful  attention  to  ascer- 
tain the  nature,  properties,  and  uses  of  this  power- 
ful remedy  ;  and  whose  vast  experience  in  its  use, 
he   declares,    "  fully  justifies   him    in   confidently 
asserting  to  the  profession,  that  it  stands  unrivalled 
as  a  curative  agent."     The  experience  of  Dr.  Nor- 
wood as  to  the  effects  of  Yeratrum  in  disease,  has 
been  corroborated  by  some  of  the  most  eminent 
physicians  of  the    Southwest.     In  a   paper   read 
before  the  Tennessee  State  Medical  Society,  and 
published  subsequently  in  the  Nashville  Journal  of 
Medicine  and  Surgery,  Professor  C.  K.  Winston 
asserts   that   the  Yeratrum  Yiride  is  an  arterial 
sedative  of  high  power  ;  that  the  most  remark'able 
and,  at  the  same  time,  the  most  important  physio- 
logical effect  of  the  remedy  is  the  reduction  of  the 


92  EXCITANTS    AND    ALTERATIVES. 

heart's  action.  The  pulse,  he  affirms,  may  be 
reduced  by  the  veratrum,  "  from  130  to  40  beats 
in  the  minute,  with  entire  safety  to  the  patient, 
and  without  the  least  injury  to  the  circulatory  or 
nervous  system." 

Employed  in  the  early  stage,  before  the  occur- 
rence of  organic  lesions,  the  Yeratrum  Yiride  is 
peculiarly  adapted  to  the  treatment  of  pneumonia, 
pleurisy,  rheumatism,  typhoid  fever,  pulmonary 
inflammation  ;  and,  in  the  phlegmasiae  generally  it 
is  regarded  as  more  or  less  valuable.  In  a  pam- 
phlet recently  published  by  Dr.  Norwood,  on  the 
"Therapeutical  Powers  and  Properties  of  Veratrum 
Yiride,"  the  author  reiterates  his  confidence  in  the 
great  value  of  the  remedy,  and  appends  the  favora- 
ble opinions  of  many  eminent  physicians  of  the 
South  and  "West,  who  have  employed  the  Veratrum 
with  great  success  in  the  treatment  of  disease. 

"We  rely  on  it,"  writes  the  author,  "as  the 
remedy  in  typhoid  fever,  and  administer  it  with 
every  assurance  of  success.  We  put  the  patient 
on  the  free  use  of  it,  and  press  it  till  every  symp- 
tom is  controlled  or  arrested.  Our  plan  is  to 
reduce  the  pulse  to  between  65  and  75  beats,  and 
keep  it  at  the  point  desired  night  and  day.  In 
some  cases,  it  should  be  reduced  at  least  to  the 
natural  standard,  if  not  below  it.  By  this  kind  of 
reduction  the  febrile  and  inflammatory  symptoms 


EXCITANTS    AND    ALTERATIVES.  93 

vanish,  and  the  patient  is  kept  quiet  and  tranquil 
and  comfortable." 

In  pneumonitis,  Dr.  Norwood  "  considers  it  as 
much  a  specific  as  Quinine  is  for  intermittent 
fever  ;  and  in  combination  with  diuretics,  in  the 
treatment  of  scarlet  fever,  he  "  finds  it  superior  to 
all  other  remedies  he  has  ever  tried."  With  regard 
to  the  power  of  the  Yeratrum  Yiride  to  reduce  the 
heart's  action,  no  doubt  whatever  can  remain. 

We  have  employed  the  remedy  frequently  since 
1851,  when  Dr.  Norwood  gave  us  a  quantity  of  the 
tincture  prepared  by  himself.  It  has  never  failed 
m  our  hands,  when  properly  administered,  to 
diminish  arterial  action.  In  one  instance  of  tuber- 
culosis, a  pulse  of  120  was  reduced  to  58  beats  in 
a  minute,  and  kept  steadily  at  that  point  day  after 
day.  Its  effect,  as  an  arterial  sedative,  has  been 
fully  tested  by  our  colleague,  Professor  Carnochan, 
on  many  of  his  patients  in  the  Emigrant's  Hospital. 
In  one  case,  a  pulse  of  130  was  reduced  68  in 
fifteen  hours  ;  and  in  a  case  of  articular  rheuma- 
tism, the  exhibition  of  the  tincture  in  doses  of  from 
five  to  eight  drops  every  three  hours,  a  pulse  of 
120  was  red/iced  to  30,  in  fifteen  hours. 

The  saturated  tincture,  "made  by  macerating 
eight  ounces  of  the  dried  root  in  sixteen  ounces  of 
alcohol  for  at  least  two  weeks,"  is  the  form  in 
which  the  remedy  is  usually  employed. 


94  EXCITANTS    AND    ALTERATIVES. 

In  the  following  combination,  the  tincture  is 
administered  by  Dr.  Norwood  : 

95. 

'^i  Tinct.  Veratri  Viride, 

Syrupi  Scillse  p.  ae. 
Misce  intim. 

Of  this  mixture  to  an  adult  male,  Dr.  Norwood 
advises  to  begin  with  from  four  to  six  drops, 
increasing  the  amount  from  one  to  two  drops  at 
each  subsequent  dose,  until  the  pulse  is  reduced, 
or  nausea  and  vomiting  are  occasioned,  when  the 
medicine  is  to  be  diminished  one-half,  and  con- 
tinued as  long  as  may  be  necessary  to  prevent  a 
return  of  the  sjmiptoms.  In  females,  commence 
with  from  three  to  four  drops,  and  increase  the 
above  until  the  necessary  result  is  obtained. 

"When  administered  to  children,  the  remedy  is 
given  in  the  following  proportions  : 

96. 

!^  Tinct.  Yeratri  Yiride,   S  ss. 
Syrupi  Scillse,     .     .      S  jss. 
Misce  bene. 

From  two  to  three  drops  of  this  combination  ma^ 
be  administered  to  children  (from  one  to  two  or 


EXCITANTS   AND    ALTERATIVES.  95 

three  years  old)  according  to  the  age,  increasing 
one  drop  at  each  subsequent  potion,  until  arterial 
action  is  reduced,  or  nausea  or  vomiting  occa- 
sioned. 

When  the  Yeratrum  is  administered  too  freely, 
nausea  and  vomiting  will,  in  some  instances,  be  very 
severe,  and  will  be  attended  with  prostration,  and 
great  coldness  of  the  surface.  When  these  symp- 
toms occur,  they  are  promptly  reheved  by  the 
administration  of  an  opiate,  and  brandy  or  any  of 
the  alcoholic  stimulants. 


CHAPTER    lY. 

CATHARTICS     AND     LAXATIVES. 

Cathartics  and  Laxatives  may  be  classed  to- 
gether, although,  as  pharmacological  agents,  a  dis- 
tinction between  them  is  of  considerable  import- 
ance in  practice. 

Cathartics  are  usually  divided  into  purgatives 
and  laxatives.  Purgatives  are  those  medicinal  sub- 
stances which,  by  producing  a  temporary  irritation 
on  the  mucous  membrane  of  the  intestines,  excite 
the  action  of  the  exhalant  and  secreting  organs  of 
these  parts,  causing  them,  thereby,  to  evacuate 
their  contents. 

Laxatives  are  those  agents  which,  by  their  relax- 
ing efforts  on  the  intestines,  excite  alvine  evacua- 
tions without  occasioning  irritation,  or  stimulating 
the  exhalants  of  this  tube. 

From  a  very  early  period  in  medicine,  purgative 
remedies  have  been  in  greater  requisition  than 
medicines  of  any  other  class  ;  and  physicians  of  all 
ages  have  considered  them  as  the  most  effectual,  cer- 
tain, and  valuable  of  all  other  therapeutical  agents. 


CATHARTICS   AND    LAXATIVES.  97 

In  the  intelligent  administration  of  these  remedies, 
it  is  necessary  to  consider  their  immediate  and  re- 
mote effects,  as  well  as  the  anatomical  structure  and 
physiological  relations  of  the  parts  affected  by  pur- 
gatives. Purgatives  act  powerfully  on  the  mucous 
membrane  of  the  small  and  large  intestines  ;  it  is 
only  by  accident  that  the  stomach  is  affected.  An 
irritation  is  set  up  on  the  intestinal  surface,  by 
exciting  the  exhalant  and  secreting  organs,  by 
which  action,  the  serous  and  mucous  discharges 
are  greatly  augmented. 

The  excretory  ducts  of  the  liver  and  pancreas 
open  on  the  interior  of  the  duodenum,  and  the 
irritation  of  their  extremities  is  communicated  to 
these  glands,  by  which  their  secreting  functions  are 
much  increased.  The  fibres  of  the  muscular  tunic, 
through  which  the  vermicular  motion  of  the  intes- 
tinal canal  is  effected,  becoming  stimulated  by 
the  action  of  purgatives,  have  their  contractions 
accelerated,  whereby  the  peristaltic  action  of  the 
intestines  becomes  more  rapid,  all  of  which  tends 
to  urge  their  contents  on  towards  the  rectum. 

"  The  irritation  caused  by  purgatives  on  the 
inner  surface  of  the  intestines,  increases  the  secre- 
tions of  the  liver  and  pancreas,  as  well  as  those  of 
the  mucous  follicles,  covering  this  surface  ;  it  aug- 
ments the  energy  of  the  intestinal  exhalants  ;  all 
these  products  flow  into  ihe  alimentary  canal,  by 

7 


98  CATHARTICS    AND    LAXATIVES. 

which  means  all  the  abdominal  organs  are  dis- 
gorged. .  .  .  During  their  operation,  the  blood 
is  carried,  in  increased  quantity,  towards  the  abdo- 
men ;  there  is,  then,  more  heat  and  increased 
movement  in  this  part  of  the  system  ;  this  increased 
action  of  the  abdominal  organs  exercises  a  deriva- 
tive or  revulsive  effect  with  respect  to  the  head 
and  chest.  The  irritation  produced  by  purgatives 
on  the  nerves  distributed  over  the  intestinal  surface, 
is  communicated  to  the  plexuses  of  the  ganglionic 
nerves,  to  the  spinal  cord — rarely  to  the  medulla 
oblongata  ;  this  movement  is  diffused  over  the 
whole  system,  and  gives  a  shock  to  the  entire 
frame."* 

In  prescribing  cathartics,  regard  should  be  had 
to  the  fact  that  each  purgative  substance  is  charac- 
terized by  a  peculiarity  of  action,  as  regards  the 
part  of  the  intestinal  canal  affected  by  it ;  mercu- 
rials produce  their  effect,  mainly  on  the  upper  por- 
tion of  the  tube  ;  Gamboge  exerts  its  influence  on 
the  stomach,  while  Aloes,  passing  by  the  superior 
portions  of  the  intestinal  canal,  spends  its  powers 
on  the  inferior  part  of  the  tube.  Hence  the  import- 
ance of  exercising  care  in  the  selection  of  a  cathartic 
to  he  prescribed,  that  the  article  may  be  adapted  to 
the  impression  we  desire  to  make. 

•  A  Manual  of  General  Therapeutics,  etc.    B7  D.  Spillan,  M.D.,  Lon- 
don,  p.  2*1*1. 


CATHARTICS    AND    LAXATIVES.  99 

When  we  wish  to  evacuate  the  contents  of  the 
bowels,  without  occasioning  irritation,  or  any  in- 
creased action  of  the  exhalants — as  in  those  diseases 
in  which  irritation  or  inflammation  of  the  gastro- 
intestinal surface  already  exists — we  then  have 
recourse  to  laxatives  or  aperients. 

In  disease,  cathartics  may  be  administered  at  any 
period  during  the  twenty-four  hours  ;  ordinarily, 
they  are  best  given  in  the  morning,  when  the  sto- 
mach is  empty.  In  intermittent  diseases  they 
should  be  administered  during  the  period  of  inter- 
mission. 

Most  physicians  of  experience  have  a  favorite 
piU^  which  they  are  accustomed  to  employ  as  their 
ordinary,  every  day  cathartic.  PiUs  composed  of 
the  following  ingredients  have  been  used  for  many 
years,  by  a  physician  of  large  experience  and 
extensive  practice,  in  Vermont : 

97. 

E«  Extract.  Aloes  Pulveris,    5  ij. 
Guaiaci  Pulveris,    .     .      5  j. 
Gambogioe  Pulveris,     .      5  iss. 

Saponis, 5j. 

Fiat  massa  et  in  pU.  Ixxxii.  aequales  div.  sumant. 
ij.  vel  iij.  pro  dosi. 

puis,  made  with  care,  of  these  ingredients,  in  the 


100  CATHARTICS  AND    LAXATIVES. 

above  proportions — the  materials  being  intimately 
pulverized  and  blended — constitute  a  most  excel- 
lent, ordinary  purgative.  From  two  to  fou?,  taken 
at  bed-time,  will  be  followed,  the  next  morning, 
by  decided  catharsis,  without  producing,  ordinarily 
any  disturbance  of  the  stomach  whatever. 

Prof.  P.,  of  New  England,  an  old  and  expe- 
rienced practitioner,  recommends  the  following  as 
'*  a  valuable  purgative,  and  every  day  cathartic  :" 

98. 

^  Ext.  Aloes  Pulv., 

Gambogise  Pulv.,     .     aa.  5  j. 
Hydrarg.  Ohio.  Mite. 
Jalapse  Pulv., 

Saponis  Dur.,       .     .     aa.  5  ss. 
01.  Ricini  Syrupi,  q.  s. 
Fiat  massa,  in  pi.  Ix.  sequales  div.,  quarum  capiat 
ij.  vel  iij.  pro  dosi. 

99. 

1^  Ext.  Aloes  Pulv.,   5  ss. 
Gambogiae,  .     .     5j. 
Rhei  Pulv.,  .     .     5  ss. 
Olei  Cinnamomi,    m.  xx. 
Syrupi  Rhamni,  q.  s. 
Fiat  massa,  in  pilulas  120  dividenda. 


CATHARTICS   AND   LAXATIVES.  101 

The  above  is  the  favorite  laxative  pUl  of  a  dis- 
tinguished lecturer  and  practitioner  of  Massachu- 
setts. 

For  overcoming  habitual  constipation  in  dyspep- 
tic patients,  the  following  are  useful  piUs  : 

.      100. 

"E^  Aloes  Socat. 

Rhei  Pulveris,   aa.  5  ij. 
Pulv.  Aromat.,  9  ij. 
Saponis,     .     .    5j. 
Syrup.  Rhamni  q.  s. 
Fiat  massa  in  pil.  Ix.  div.  quarum  sumat  ij.  pro 
dosi. 

101. 

Ef  Extract.  Aloes  Pulv. 

Rhei  Pulv.,      .    .    aa.  5  j. 
Ipecac.  Pulv. 

Sapon.  dur.,     .     .     aa.  5  ss. 
Fiat  massa  et  in  pil.  xxx.  div.  siunat.  j.  vel  ij.  pro 
dosi. 

By  some  practitioners,  the  above  pill  is  preferred 
In  the  habitual  constipation  of  dyspeptics. 

The  following  were  the  favorite  anti-dyspeptic 
piUs  of  Dr.  Chapman  : 


102  CATHARTICS   AND    LAXATIVES. 

102. 

B»  Extract.  Aloes,     .     5  J. 
Ipecacuanhge  Pulv.,   9j. 
Mastich,       .     .     .     5j. 
Olei  Faeniculi,  .     .     gtt.  xx. 
Fiat  massa  in  pil.   xl.  div.   sumat  una  mane 
nocteque. 

Many  distinguished  physicians  of  this  country 
are  accustomed  to  combine  a  small  amount  of  Calo- 
mel and  Tartarized  Antimony,  in  their  ordinary 
aperient  pill : 

103. 

B»  Extract.  Aloes,    .     .     5  ss 
RheiPulv.,     .     .     .     5j. 
Hydr.  Chlorid.  Mite,     gr.  iv. 
Ant.  et  Potass.  Tart.,    gr.  ij. 
M.  intim.     Ft.  massa  et  in  pil.  xxx.  divid.  sumat 
ij.  pro  dosi 

The  above  are  the  favorite  cathartic  pills  of  many 
Southern  practitioners. 

Dr.  Cox,  of  Maryland,  commends  the  following 
as  a  valuable  cathartic  pill : 


CATHARTICS   AND   LAXATIVES.  103 

104. 

B»  Hydrarg.  Chlorid.  Mite, 

Extract.  Coloc3nith.  Co.,  aa.  9  ij. 
01.  Tiglii  Croton.,   .     .     gtt.  ij. 
M.  Fiat  massa  et  in  pil.  xii.  divid.  capiat  ij.  vel 
iij.  pro  dosi. 

105. 

]^  Massae  Hydrarg., 
Rhei  Pulv., 

Extract.  Aloes,      aa.  5  ss. 
01.  Tiglii  Croton.,  gtt.  iv. 
SodaB  Bi-Carb., 
Capsici  Pulv.,  .     aa.  gr.  xii. 
M.  Fiat  Mass.  et  in  pil.  xxx,  div.  sumat  j.  vel  ij., 
hora  decubitus. 


The  above  is  considered  an  excellent  aperient  by 
the  same  eminent  practitioner 

With  many  patients,  aperient  mixtures,  or  elec- 
tuaries, are  preferred  to  pills.  The  following  mild 
laxative  mixture,  which  was  originally  prescribed 
by  an  eminent  physician  of  Virginia,  has  been  since 
employed  by  many  practitioners  of  our  acquaint- 
tance — all  of  whom  speak  of  it  as  a  most  excellent 
and  efficient  aperient : 


104  CATHARTICS   AND   LAXATIVES. 

106. 

Ijt  Alo*es  Soc.  Pulv.,     .     5  v. 
Sodae  Bi-Carb.,    .     .     5  iss. 
Tr.  Lavendul.  Comp.,  f.  S  ss. 
Aquae  puree,   .     .     .     f.  Oj. 
Fiat  mistura,  cujus  capiat  coch.  j.  mag.  quo- 
tidie. 

After  constipation  is  overcome  by  the  administra- 
tion of  the  medicine  in  the  above  doses,  a  teaspoon- 
ful  taken  at  bed-time  will  in  most  persons  be  suffi- 
cient to  keep  the  bowels  in  a  soluble  condition. 

In  cases  of  constipation,  attended  with  flatulence 
or  acidity,  an  experienced  practitioner  of  Yirginia, 
highly  recommends  the  subjoined  : 

107. 

E«  Extract.  Aloes  Pulv.,  5  iij. 

Potassae  Bi-Carb.,     .  5  vj. 

Syrupi  Khei  Aromat.,  f.  S  ij. 

Sp.  Lavendul.  Comp.,  f.  5  ij. 

Aquae  purae,     .     .     .  f.  S  vj. 
Piat  mistura,  ctvjus  capiat  coch.  parv.  una  me- 
ridie  nocteque. 

Physicians  are  frequently  called  on  to  prescribe 
for  cases  of  habitual,  or  occasional  costiveness,  in 
which  laxatives,  although  indicated,  yet  have  the 


CATHARTICS   AND   LAXATIVES.  105 

effect  to  weaken  the  patients,  or  induce  debility  of 
the  alimentary  canal,  whenever  they  are  adminis- 
tered. Under  such  circumstances,  our  colleague, 
Professor  Peaslee,  has  been  accustomed  to  employ, 
for  many  years,  in  his  practice,  the  subjoined  mix- 
ture, which  is  a  combination  of  a  tonic  and  a  laxa- 
tive, and  which,  after  years  of  experience  in  its  use, 
he  assures  us,  is  admirably  adapted  to  such  cases — 
being  especially  useful  in  troublesome  constipation 
occurring  in  feeble  persons,  and  in  that  which  often 
attends  convalescence  from  fevers  and  other  severe 
diseases.  It  may  be  employed  for  several  weeks 
in  succession  without  irritating  or  weakening  the 
alimentary  canal : 

108. 

"Ef  Rad.  Columbae  Contus.,  S  ss. 

Fol.  Sennae,       .     .     .  S  j. 
Extract.  Taraxaci 

Mannse aa.  S  ss. 

Aquae  fervent,       .     .  f  S  xij. 
Macera  per  horam,  cola 

et  adde  Holland  Gin,  S  iv. 

M.  Sumat  cochleare  mag.  j.  vel  ij.  pro  dosi. 

The  above  is  also  an  excellent  vehicle  for  the 
administration  of  Iron  and  other  tonics,  in  cases  of 


106 


CATHARTICS  AND   LAXATIVES. 


anemia  and  dyspepsia,  accompanied  by  constipa- 
tioiu 

When  it  is  desirable  to  employ  a  very  certain 
cathartic  in  cases  of  obstinate  constipation,  arising 
particularly  from  inaction  of  the  liver,  or  from 
other  causes,  the  same  physician  places  great  re- 
liance in  the  following  mixture  : 


109. 

"Bji  Extract.  Aloes,     ...     5  ij. 
Extract.  Taraxaci,     .     .     S  ss. 
Sennse  Fol.,     .     .     .     .     S  j. 
Rhei  Contus.,  ....     5  iij. 
Kucis  Vomicae  Pulv.,     .     5  iss. 
Aquae  fervent.,     .     .     .     f.  S  xij. 
Macera  per  horam,  cola  et 

adde  Magnesiae  Sulph.,    5  iss. 
Holland  Gin,    .     .     .     .     5  iv. 
M.  Cujus  sumat.  cochl.  mag.  pro  dosi,  secundS 
quaque  hora,  donee  alvus  soluta  sit. 


In  robust  adults,  two  tablespoonfuls  may  be 
administered  at  first,  followed  by  one  spoonful 
every  two  hours  until  rehef  is  obtained. 

A  tablespoonful  may  be  taken  every  night  to 
prevent  a  recurrence  of  the  constipatioTi. 


CATHARTICS  AND  LAXATIVES.  107 

110. 

!^  Magnesiae  Carb.,       .  S  ij. 

Rhei  Pulveris,     .     .  5  iss. 
Tinct.  Rhei, 

Syrupi  Simp.,       .     .  f.  aa.  S  j. 

Aqu88  MenthaB  Piper.,  f.  S  iv. 

M.  Fiat  mistura,  cujus  capiat  cochl.  mag.  j.  pro 
re  nata. 

The  above  is  a  very  gentle  and  excellent  aperient 
in  some  forms  of  dyspepsia,  attended  with  flatu- 
lency or  acidity  of  the  stomach. 

Prof.  J.  H.  Dixon  is  accustomed  to  employ  the 
following  cathartic  mixture  : 

111. 

^RheiPulv.,  5j. 

Magnes.  Sulph., gj. 

01.  A  nisi  vel  Menth.  vel  Sassif.,  gtt.  ij. 

Aquae  purae, f.  S  vj. 

Fiat  mistura,  sumat  cochl.  mag.  j.  vel.  ij.  pro 
dosi. 

An  excellent,  active  cathartic,  writes  Dr.  F.  Y. 
Porcher,  of  Yirgmia,  is  the  following.  In  dropsical 
affections  accompanied  by  high  arterial  action,  it 
procures  copious  alvine  evacuations,  and  often,  at 
the  same  time,  a  copious  flow  of  urine  : 


108  CATHARTICS  AND   LAXATIVES. 

112. 

]^  Sodge  Sulph.,  Potassae  bitart.,  aa.  S  j. 
Sp.  aether,  nitrici,        .     .     .     .    5  iij. 

Aquae  purae, S  viij, 

M.  Sumat  cochl.  mag.  ij.  pro  re  nata. 

As  a  roild  and  refrigerant  aperient  in  febrile 
complaints,  the  subjoined  mixture  may  be  given 
when  a  laxative  operation  is  desired.  It  may  also 
be  advantageously  prescribed  for  patients  laboring 
under  torpidity  of  the  liver. 

113. 

!^  Infusi  Sennae  Comp.,  f.  5  iij. 

Rhei  Pulveris,   .     .  5  j. 
Tinct.  Sennae, 

Tinct.  Cardam.  Co.,  aa.  f.  5  iij. 

Syrupi  Zingib.,  .     .  f.  5  ij. 
M.  Fiat  mistura,  cujus  sumat  cochl.  ij.  ampji.  pro 
re  nata. 

The  physician  is  not  unfrequently  called  upon 
to  prescribe  for  patients  enfeebled  by  chronic  dis- 
ease, in  whose  cases  tonics,  although  indicated,  are 
not  well  borne  because  of  the  presence  of  a  de- 
ranged condition  of  the  digestive  organs.  In  such 
cases  we  have  often  administered  for  a  week  or 


CATHARTICS   AND   LAXATIVES.  109 

ten  days  the  following  aperient  alterative  pill ; 
after  which,  tonics,  may,  generally,  be  advan- 
tageously exhibited : 

114. 

]^  Extract.  Hybscyami,  5  j. 
Massae  ex  Hydrarg.,  9  j. 
Ipecacuanhae  Pulv.,    3j. 
Fiat  massa  in  pil.  xl.  div.  snmat  unam  mane 
nocteque. 

Under  the  same  circumstances  as  above.  Profes- 
sor T .  of  New  Haven,  recommends  the  follow- 
ing : 

115. 

"E^  Hydrarg.  Chlorid.  Mite,  gr.  iv. 
Capsici  Pulveris, 
Extract!  Conii,      .     .     aa.  5  j. 
M.  Fiat  mass,  in  pil.  xxxii.  divid. 

One  of  these  pills  may  be  administered  morning 
and  evening.  In  dyspeptic  phthisis,  in  cases  of 
ordinary  dyspepsia,  attended  with  inaction  of  the 
hver,  the  exhibition  of  these  pills  for  a  short  time 
will  often  prepare  the  system  for  the  administra- 
tion of  a  tonic  or  supporting  plan  of  treatment. 


110  CATHARTICS   AND    LAXATIVES. 

116. 

]^  Ext.  Aloes  Pulv.,  .    5j. 
Ferri  Sulphatis,      .    5  j. 
Ext.  Hyoscyami.,  .    5  j. 
Ext.  Nucis  YomicaB,  gr.  x. 
M.  Fiat  massa  et  in  pilulas  Ix.  dividenda,  qua- 
rum  sumat  j.  mane  ac  nocte. 

The  above  pills,  Prof.  Davis  assures  us,  he  has 
used  many  years  with  the  most  satisfactory  results^ 
in  cases  of  imperfect  digestion  comphcated  with 
habitual  constipation.  One  pill  each  night,  or  one 
night  and  morning — sufficient  to  procure,  daily,  a 
regular  intestinal  evacuation,  should  be  adminis- 
tered. 

117. 

!^  Ext.  Aloes  Pulv.,    .     3j. 
Ehei  Pulv., 
Jalapae  Pulv., 

Scammon.,      .     .     .     aa.  gr,  xvj. 
Ant.  et  Potass.  Tart.,  gr.  j.  vel  ij. 
Olei  Croton.,       .     .     gtt.  j.  vel  ij. 
Gambogiae,     .     .     .     gr.  vj. 
Fiat  massa  et  in  pil.  Ixiv.  divid.  quarum  capiat 
unam  vel  duos  in  die,  post  prandimn. 

The  above  piU,  writes  Dr.  John  Ware,  of  Bos- 


CATHARTICS   AND    LAXATIVES.  Ill 

ton,  "  I  have  used  very  much  for  habitual  costive- 
ness.  It  has  been  used  a  good  deal  in  this  city, 
and  is  kept  by  some  of  the  druggists  under  the 
name  of  the  compound  Alvine  piU." 

In  habitual  constipation,  the  following  cathartic 
or  eccoprotic  pill,  is  highly  cominended  by  Dr. 
Dickson,  of  South  Carolina.  One  or  two  of  the 
pills  are  advised  by  him,  to  be  taken  every  second 
night,  on  going  to  bed. 

118. 

"Eji  Extract.  Belladon.,  gr.  v. 
Rhei  Pulv., 

Extract.  Aloes,    .    aa.  gr.  xvj. 
M.  Fiat  massa  in  pil.  xii.  div. 

119. 

The  best  remedy  I  have  ever  tried,  writes  Prof. 
Lindsly,  in  habitual  constipation,  is  to  take  half  a 
drachm  of  Epsom  Salts,  dissolved  in  half  a  pint  of 
water — adding  ten  drops  of  Elixir  of  Vitriol — one 
hour  before  breakfast.  The  smaller  the  dose  of 
salts  the  better,  provided  it  will  operate.  It  may 
be  taken  for  weeks,  till  a  cure  is  effected. 


CHAPTER  Y. 

EMETICS    AND     EXPECTORANTS. 

We  may  arrange  Emetics  and  Expectorants 
together,  inasmuch  as  some  of  the  direct  emetics 
are  among  the  best  remedies  for  promoting  expec- 
toration ;  although  as  therapeutical  agents,  and  in 
a  pharmacological  sense,  they  are  widely  different 
in  many  instances. 

Emetics  are  those  substances  which  excite  vomit- 
ing. Expectorants  are  the  medicinal  agents  which 
possess  the  property  of  increasing  the  secretion 
from  the  pulmonary  mucous  membrane.  Direct 
emetics  operate  by  an  irritation  which  they  cause 
of  the  gastro-duodenal  surface.  The  production  of 
vomiting  has  been  thus  explained  :  "  The  irritation 
of  the  stomach  makes  a  call  upon  the  brain  for  the 
aid  of  the  diaphragm  and  the  abdominal  muscles,  in 
order  to  expel  its  contents  ;  the  diaphragm  then 
becomes  contracted  and  fixed,  the  ribs  drawn  down, 
the  abdominal  muscles  drawn  inwards,  so  that  the 
stomach  is  pressed  on  all  sides  by  voluntary  mus- 

112 


EMETICS    AND    EXPECTORANTS.  11 0 

cles,    which,    together    with   its   own   contraction, 
expels  the  contents." 

In  the  administration  of  an  emetic,  the  irritation 
of  the  gastric  and  duodenal  surface  is  communi- 
cated to  the  mucous  follicles  of  these  parts,  by 
which  the  ordinary  ^^xbAlatioo  ls  accelerated  and 
greatly  increased  ;  the  irritation  of  the  mouths  of 
the  excretory  ducts  of  the  liver  and  pancreas, 
^hich,  as  we  have  seen,  open  on  the  duodenal  sur- 
face, is  transmitted  to  these  glands,  by  which  their 
fluids  become  quickly  augmented,  and  the  bile 
thus  secreted  in  increased  quantity,  flows  into  the 
duodenum,  from  thence  it  ascends  into  the  sto- 
mach and  is  rejected  by  the  mouth.  "  We  are  not 
to  suppose  that  all  the  bile  passed  by  vomiting 
existed  in  the  stomach  or  primae  vias  before  the 
emetic  was  taken.  The  secretion  of  this  fluid  is 
caused  by  the  emetic,  and  is  the  result  of  its  influ- 
ence upon  the  hver."  * 

In  the  operation  of  an  emetic,  not  only  is  an 
action  aroused  in  the  viscera,  to  which  we  have 
alluded,  but  an  irritation  is  communicated,  through 
the  nervous  filaments  of  the  stomach,  which  are 
received  from  the  pneumogastric  nerve  to  the 
medulla  oblongata,  and  finally  to  the  whole  gan- 
glionic system  of  nerves  ;  so  that,  by  reason  of  the 

*  Haaual  of  Gea.  Thera.,  p.  254. 
8 


114  EMETICS    AND    EXPECTORANTS. 

sympathetic  connections  which  the  stomach  main- 
tains with  the  different  centres  of  innervation,  the 
shock  caused  by  the  administration  of  an  emetic  is 
at  once  transmitted  throughout  the  entire  system. 
Hence  it  is  that  the  well-timed  exhibition  of  an 
appropriate  emetic  will  often  destroy  disease  in 
embryo. 

As  in  selecting  cathartics  the  physician  is  guided 
by  the  indication  to  be  fulfilled,  so  in  the  adminis- 
tration of  emetics  it  is  important  that  the  emetic 
agent  chosen,  should  be  adapted  to  the  existing  cir- 
cumstances or  nature  of  the  disease  prescribed  for. 

There  often  occurs  a  morbid  state  of  the  diges- 
tive organs,  manifested  by  a  sense  of  fullness  in  the 
epigastrium,  a  loss  of  appetite,  a  bitter  taste  in  the 
mouth,  the  tongue  is  moist,  and  is  covered  with  a 
whitish  coat ;  symptoms  which  indicate  turgescence 
of  the  liver,  and  a  congested  condition  of  the  gas- 
trO-duodenal  mucous  membrane.  Under  such  cir- 
cumstances the  following  emetic  is  indicated : 

120. 

Tji  Ant.  et  Potassae  Tartrat.,  gr.  ij. 
Ipecacuanhge  Pulv.,      .      3j. 
Aquge  puras,        .     .     .      f.  S  iv. 
Piat  mistura,  sumat  cochleare  j.  amplum  omni 
horse  quadrante  donee  super  venerit  vomitas. 


EMETICS   AND    EXPECTORANTS.  115 

In  administering  Tartarized  Antimony  to  young 
children,  great  caution  should  always  be  observed. 
We  have  before  attempted  to  show  the  uncertain, 
energetic,  and  often  dangerous  effects  of  this  pow- 
erful agent,  when  administered  in  continued  doses 
to  young  persons.*  In  membranous  croup,  and 
some  other  acute  diseases  of  children.  Emetic  Tar- 
tar, when  employed  to  a  certain  extent,  and  with 
that  caution  which  should  always  be  observed  when 
administering  so  powerful  an  agent,  is  an  invalua- 
ble remedy  ;  but  after  one  or  two  exhibitions  of 
this  remedy  some  other  agent  should  be  substituted, 
when  it  becomes  necessary  to  repeat  the  emetic 
operation  in  the  course  of  the  progress  of  the  same 
disease. 

121. 

1^  Ant.  et  Potass.  Tart.,  gr.  j. 
Ipecacuanhae  Pulv.,      9  ss. 
Aqufie  tepidse,     .     .     f .  S  iv. 
Fiat  mistura,  sumat  cochleare  parv.  omni  horae 
quadrante  ad  emesim. 

In  the  commencement  of  croup,  the  above  may 
be  administered  in  teaspoonful  doses,  once  in  five, 
ten,  or  fifteen  minutes,  according  to  the  urgency 
of  the  symptoms,  until  vomiting  is  effected.    Should 

*  Observations  on  the  Pathology  and  Treatment  of  Croup,  pp.  104-'7. 


116  EMETICS   AND   EXPECTORANTS. 

the  continuance  and  severity  of  the  disease  require 
the  emetic  operation  to  te  several  times  repeated, 
the  following  combination  may  be  substituted. 
We  have  found  it  to  be  one  of  the  most  certain, 
efficacious,  and  safe  emetics  that  can  be  adminis- 
tered. 

122. 

^i  Zinci  Sulphatis,    .     gr.  x. 

Ipecacuanhae  Pulv.,  3j. 

Aquae  tepidae,      .     f  5  iv. 
Fiat  mistura. 

This  emetic  may  be  administered  under  the  same 
circumstances  as  the  preceding,  and  to  the  same 
amount. 

Turpeth  Mineral  is  another  active  mineral  emetic, 
much  employed  by  some  practitioners  in  New 
England,  in  the  treatment  of  membranous  croup. 

Come  years  ago  the  attention  of  the  profession 
was  called  to  the  properties  of  this  remedy  by  Dr. 
Hubbard,  of  Maine,  who  highly  recommends  it  as 
a  certain  and  sure  remedy  in  croup. 

123. 

^  Hydrarg.  Sulph.  Flav.,  gr.  x. 
Syrupi  SimpUcis,      .     f.  5  ss. 
M.  Cap.  cochl.  parv.  j.  ©miai\.  horae  quadrante,  ad 
effectum. 


EMETICS   AND   EXPECTORANTS.  117 

In  cases  of  poisoning,  where  it  becomes  import- 
ant to  evacuate  the  stomach  as  quickly  as  possible, 
and  to  prevent  absorption,  an  emetic  which  occa- 
sions but  little  nausea,  and  operates  promptly, 
should  be  selected. 

124. 

!^  Cupri  Sulphatis,  gr.  x. 

AquaB  tepidaB,      f.  S  ij. 

M.  Fiat  haustus  emeticus.     Yel : 

^  Zinci  Sulphatis,  gr.  xv. 
Aquas  tepidae,    f.  S  ij. 
M.  Fiat  haustus  emeticus. 

In  the  treatment  of  haemorrhage,  particularly 
haBmorrhage  from  the  lungs,  some  eminent  Ameri- 
can practitioners  are  accustomed  to  place  much 
rehance  on  the  use  of  nauseating  emetics,  it  being 
well  known  that  the  force  of  the  circulation  is 
greatly  diminished  during  the  period  of  nausea. 
The  following  is  a  suitable  emetic  in  haemorrhage  : 

125. 

^  Ipecacuanhae  Pulv.,  .     9j. 
Aquae  Menth.  Pulegii,  f.  S  iv. 
Fiat  mistura,  sumat  cochleare  mag.  j.  omni  horae 
quadrante  ad  emesim. 


118  EMETICS    AND    EXPECTORANTS. 

In  the  treatment  of  chronic  diarrhoea  and  dysen- 
tery, emetics  act  in  some  cases  as  revellents,  and 
thus  prove  very  serviceable. 

126. 

"Sjt  Ipecacuanhae  Pulv.,  gr.  xv. 
Aquae  Menth.  Pip.,  f.  S  iv. 
Fiat  mistura. 

The  above  may  be  given  in  divided  doses  in 
chronic  diarrhoea. 

Among  the  vegetable  emetics  are  two  remedies 
much  used  among  some  American  practitioners, 
particularly  in  the  treatment  of  croup,  and  spas- 
modic asthma  ;  these  are  the  Sanguinaria  Cana- 
densis and  the  Lobelia  Inflata.  Bloodroot  is  an 
acrid,  stimulating  emetic,  and  has  been  highly 
extolled  by  some  physicians,  in  croup,  in  asthma,? 
and  in  pertussis.  It  is  administered  as  an  emetic 
in  the  form  of  infusion,  and  the  saturated  tincture 
of  the  root. 

127. 

^  Sanguinariae  Canadensis,   Sj- 
Aquae  ferventis,  .     .     .    Oss. 
Macera.    Sumat  cochl.  ampl.  omni  horae  quad- 
rante  ad  emesim. 


EMETICS   AND   EXPECTORANTS.  119 

The  tincture  of  Sanguinaria,  administered  in  tea- 
spoonful  doses,  is  equally  effective  as  an  emetic. 

Lobelia  is  an  active  and  powerful  remedy,  and  is 
seldom  employed  as  an  ordinary  emetic.  But  in 
the  treatment  of  spasmodic  asthma,  it  is  esteemed 
by  many  as  a  most  efficient  and  valuable  thera- 
peutic agent.  The  officinal  tincture  is  the  best 
form  m  which  to  administer  Lobelia  as  an  emetic. 
In  asthma,  it  may  be  given  in  doses  of  from  one  to 
two  fluid  drachms,  repeated  every  half  hour,  or 
oftener,  until  vomiting  occurs,  or  relief  is  obtained. 
If  continued  for  any  length  of  time,  however,  in 
full  doses,  it  is  apt  to  produce  distressing  relaxa- 
tion. It  is,  therefore,  advised  not  to  continue  the 
remedy  beyond  three  or  four  doses,  if  vomiting 
does  not  follow. 

To  relax  the  spasm,  in  attacks  of  asthma,  some 
practitioners  administer  the  tincture  in  half  drachm 
doses  every  half  hour,  sufficient  to  effect  nausea  for 
a  time  without  producing  vomiting,  and  they  as- 
cribe to  the  medicine  thus  exhibited  most  extraor- 
dinary efficacy,  occasionally,  in  the  paroxysm  of 
spasmodic  asthma. 

128. 

^  Tinct.  Lobehae  Inflatas, 

Syrupi  Scillse,  aa.     .     .    f .  S  j. 
M.  Sumat  M.  xx.  vel  xxv.  bis  terve  in  die. 


120  EMETICS    AND    EXPECTORANTS. 

The  above  combination  has  been  recommended 
by  experienced  physicians  in  the  treatment  of 
hooping  cough.  In  doses  of  twenty  or  thirty  drops, 
it  may  be  administered  with  safety,  and  often  with 
much  advantage,  several  times  a  day  to  young 
children  affected  with  hooping  cough. 

Expectorants,  we  have  stated,  are  those  medici- 
nal agents  which  are  supposed  to  have  the  power 
of  increasing  the  secretion  from  the  pulmonary 
mucous  membrane,  and  of  aiding  in  the  expulsion 
of  secreted  matter  from  the  air-passages.  Expec- 
torants are  frequently  given  in  combination  with 
alteratives  ;  and,  to  allay  irritation,  in  some  forms 
of  bronchial  and  pulmonary  disease,  they  are,  with 
advantage,  frequently  combined  with  sedatives. 

In  chronic  bronchitis,  and  in  catarrhal  affections, 
after  the  inflammatory  symptoms  are  somewhat 
subdued,  we  have  found,  after  much  experience  in 
its  use,  the  following  to  be  a  most  valuable  expec- 
torant : 

129. 

!1^  Decoct.  Polygalae  Senega3,  f.  5  iv. 
Potass.  lodid.,  .     .     .     .     5  ij. 
Yini  Antimonii,     .     .     .     f.  S  ss. 
Syr.  Tolutan.,    ....     f.  5  iss. 
Fiat  mistura,  capiat  cochl.  parvum  bis  terve  in 
die. 


EMETICS   AND   EXPECTORANTS.  121 

A  similar  combination  is  liigUy  recommended 
by  Dr.  Stokes  for  the  treatment  of  bronchitis.* 

For  cases  of  chronic  bronchial  disease,  attended 
with  profuse  expectoration,  the  subjoined  stimu- 
lant expectorant  has  been  much  commended  : 

131. 

!1^  Misturae  Ammoniaci,  f.  5  vi. 
Syr.  ScillcB,    .     .     .     f.  S  j. 
Tr.  Opii  Camph.,    .     f  S  ss. 
Tinct.  Hyoscyami,  .     f  5  j. 
Yini  IpecacuanhjB,       f.  5  iij. 
Fiat  mistura,  cujus  capiat  cochl.  mag.  pro  dosi. 

In  the  treatment  of  both  bronchial  and  pulmo- 
nary disease  the  following  mixture  is  highly  recom- 
mended by  an  eminent  physician  of  Connecti- 
cut : 

*  "  Among  the  local  or  specific  stimulants  in  bronchitis,"  says  Dr. 
Stokes,  in  hia  work  on  Diseases  of  the  Chest,  "  I  know  of  none  to  be  com- 
pared with  the  following : 

180. 

5  Decoct.  Polygalae  Senegae,     f.  §  v. 
Syr.  Tolu.  Tr.  Opii  Camph., 
Tinct.  Scillae,  aa.      .     .     .     f.  3  ij, 
Ammonisa  Carb.,      .    .    .    gr,  xv.  vel  xx. 

Fiat  mistura." 


122  EMETICS   AND   EXPECTORANTS. 

132. 

'Eji  Syrupi  Scillse  Conip., 

Syrupi  Tolutan.,  aa.  f.  5  ij. 
Tinct.  Sanguinarice,  f.  S  j. 
Tinct.  Lobelise,  .  f.  5  vj. 
Tinct.  Camphori,  .  f.  5  ij. 
Acidi  Hydrocyanici,  m.  xl. 
Fiat  mistura,  sumat  cochl.  parv.  pro  re  nata. 

When  the  cough  is  severe,  from  two  to  four 
grains  of  the  Sulphate  of  Morphia  may  be  added 
to  the  above  mixture. 

The  subjoined  antispasmodic  cough  mixture  has 
been  recommended  by  Prof  S.  H.  Dickson,  as  a 
remedy  well  adapted  "  to  pertussis,  and  to  all  ner- 
vous and  habitual  coughs." 

133. 

^  Potass.  lodid.,  .  .  5  iss. 
Aquae  Amygd.  Amar.,  f.  5  iij. 
Tinct.  Mosch.  Fact.,  f.  5  ij. 
Tinct.  Opii  Camph.,  f.  5  ij. 
Aquae  purae,  .  .  .  f.  S  iv. 
Fiat  mistura,  sumat  cochl.  parv.  pro  re  nata. 

In  troublesome  and  chronic  cough.  Prof  Cox 
recommends  the  following : 


EMETICS   AND    EXPECTORANTS.  123 

134. 

'^^  Decoct.  Potygalaj  Senegae,  f.  S  iv. 
Syrupi  Tolutan.,    .     .     .     f.  S  ss. 
Morph.  Sulph.,       .     .     .     gr.  j. 
Ext.  Pruni  Yirgin.,     .     .     S  ss. 
Fiat  mistura,  sumat  cochl.  ampl.  pro  re  nata. 

135. 

^  Polygalae  Senegae  Pulv.,   5  ij. 
Ipecacuanhae  Pulv.,     .     5  j. 
Mel.  Opt,      .     .     .     .     S  ij. 
Aquae  fervent.,  .     .     ,     S  vj. 
Fiat  mistura,  cujus  sumat  cochl.  parv.  pro  re 
nata. 

The  above  is  the  ordinary  expectorant  pre- 
scribed by  Prof. ,  of  Philadelphia,   in  the 

treatment  of  catarrhal  affections.  It  is  a  very  use- 
ful remedy  in  the  early  stage  of  bronchial  irritation, 
and  may  be  employed  before  the  more  stimulant 
expectorants  are  indicated. 

In  catarrhal  and  bronchial  inflammation  of  child- 
ren, when  it  becomes  important  to  promote 
promptly  the  expulsion  of  phlegm  from  the  bron- 
chi, the  following  combination  will  be  found  to  be 
of  great  efficiency  : 


124  EMETICS   AND   EXPECTOKANTS. 

136. 

]^  Decoct.  Polyg.  Seneg.,  f.  S  iij. 
Oxymel.  Scillae, 
Vini  Ipecacuanhas,  aa.    f.  5  ij. 
Yini  Antimonii,     .     .     f.  S  ss. 
M.  Et  exhibe  m.  xv. — xxv.  omni  horse  quad- 
rante  ad  emesim. 

After  the  occurrence  of  nausea  or  vomiting,  it 
may  be  administered  in  diminished  doses  once  in 
two  hours,  sufficient  to  promote  expectoration. 

As  stimulant  expectorants,  the  balsams  are  fre- 
quently employed,  alone,  or  in  combination  with 
nauseants  and  sedatives.  Among  this  class  of 
remedies  the  Canadian  Balsam  is  one  of  the  most 
agreeable  and  useful,  and  is  much  employed  in 
some  parts  of  the  United  States  and  in  the  Canadas. 

137. 

^  Balsam.  Canadensis, 
Liquor.  Potass.,  aa.  f  5  j. 
Yini  Ipecacuanhse,    f  S  ss. 
Syrupi  Tolutanis,       f  S  iss. 
Aquae  font.,     .     .     f-  S  ij. 
Fiat  mistura,  sumat  cochl.  parv.  bis  terve  in  die. 

A  useful  remedy  in  chronic  catarrhal  and  bron- 
chial affections. 


EMETICS   AND    EXPECTORANTS.  125 

The  following  combination  is  the  favorite  expec- 
torant and  cough  mixture  of  a  distinguished  physi- 
cian of  Montreal : 

138. 

I^  Balsam.  Canadensis,  f.  5  vj. 

Potass.  Cyanidi,  .     gr.  iss. 

Tinct.  Aconiti,  .     f.  5j. 

Liquor.  Potass.,  ,     f.  5  j. 

Syrupi  Tolutan.,  .     f.  S  ss. 

Aqu9e  font.,     .  .     f .  S  iijss. 

Fiat  mistura  cujus  sumat  cochl.  parv.  pro  re 
nata. 

In  chronic  bronchial  disease,  and  in  long-con- 
tinued catarrhal  affections  which  are  attended  with 
a  copious  muco-purulent  expectoration,  the  Balsam 
of  Copaiba  is  a  valuable  stimulant  expectorant. 

139. 

^  Copaiferae  Officinalis,  f.  5  ss. 

Tinct.  Opii  Camph.,  f.  5j. 

Vini  Ipecacuanhge,  f.  S  ss. 

Sjnrupi  Acaciae,  .     .  f .  S  ij. 

01.  Gaultheriae,  .     .  gtt.  xx. 
Fiat  mistura,  capiat  cochl.  parv.  bis  in  die,  vel 
ssepius. 


126  EMETICS   AND    EXPECTORANTS. 

In  the  treatment  of  chronic  diseases  of  the  air 
passages,  the  following  mixture  is  strongly  recom- 
mended by  an  experienced  practitioner,  as  an  effi- 
cient remedy  for  allaying  the  cougl/  and  diminish- 
ing the  expectoration  : 

140. 

^  Morphias  Acetat.,     .     gr.  iv. 
Potass.  Cyanidi,       .     gr.  iij. 
Yini  Antimonii, 
Yini  Ipecacuanhse,  aa.  f:  5  ij. 
Tr.  Sanguinarias,      .     f.  S  ss. 
Syrupi  Tolutanis,     .     f.  S  iij. 
Fiat  mistura,  cujus  capiat  cochl.  parv.  ter  qua- 
terve  in  die. 

As  a  mild  expectorant  for  young  children,  when 
threatened  with  an  attack  of  croup,  or  in  the  com- 
mencement of  bronchitis  or  catarrhal  fever,  the  fol- 
lowing mixture  will  prove  highly  useful : 

141. 

!1^  Yini  Ipecacuanhse,   f.  5  iij. 
Sjrrupi  Tolutani,  .    f.  5  v. 
Mucilaginis  Acacias,  f.  S  j. 
Fiat  mistura,  sumat  cochl.  parv.  omni  hor^  vel 
quaque  secunda  horsi. 


EMETICS   AND    EXPECTORANTS.  127 

Among  some  valuable  formulae  contributed  by 
Professor  N.  S.  Davis,  of  Chicago,  are  several 
most  excellent  remedies  for  the  treatment  of  tho- 
racic disease. 

142. 

'^^  Glycerin.,      .     .     f .  g  iij 
Syr.  Ferri  lodid.,  f.  S  ss. 
Morphiae  Sulph.,     gr.  ij. 
Fiat  mistura,  capiat  cochl.  parv.  ter   quaterve 
in  die. 

"To  allay  cough,  retard  emaciation, and paUiate 
the  symptoms  of  phthisis  pulmonahs,"  writes  Dr. 
Davis,  "  I  have  no  remedy  superior  to  the  above  j 
or,  the  following,  namely  : 

143. 

^  Glycerin.,        .     .     f .  S  iij. 
Sodae  Hypophos.,      S  j. 
Morphias  Sulph.,       gr.  iij. 
Fiat  mistura,  cujus  capiat  cochl.  parv.  ter  qua- 
terve in  die." 

Whenever  the  anodyne  effect  of  Opium  is  needed, 
and  the  ordinary  preparations  of  that  article  al- 
ways produce  secondary  vomiting  and  exhaustion, 
as  is  the  case  with  many  patients.  Dr.  Davis 
recommends  the  following  combination  : 


128  EMETICS   AND   EXPECTORANTS. 

144. 

^i  Magnesiae  Sulph.,     .      5  ij. 
Acidi  Sulph.  Aromat., 
Tinct.  Opii,  aa.    .     .     f.  5  ij. 
Aquae  font.,     .     .     .     f.   S  ij. 
Fiat  mistura,  sumat  cochl.  parv.  pro  re  nata. 


CHAPTER    VI. 


ASTRINGENTS. 


Astringent  medicines  are  usually  defined,  sub- 
stances whicli  coming  in  contact  with  living  organ- 
isms corrugate  and  condense  their  fibres,  and  thus 
diminish  the  action  of  secretion  and  excretion. 
As  astringents  exert,  ultimately,  a  tonic  influence 
on  the  human  body,  and  as  some  tonics  often  prove 
astringent,  many  writers  have  considered  tonics  and 
astringents  as  identical.  Tannin,  which  is  an  im- 
portant ingredient  in  many  astringents,  is  not  indis- 
pensable to  tonics  ;  in  many  respects,  however, 
they  appear  to  be  very  nearly  allied.  Some  of  the 
most  powerful  of  the  astringent  remedies  are  de- 
rived from  the  mineral  kingdom,  but  by  far  the 
largest  and  most  important  portion  of  this  class  of 
medicinal  substances  is  obtained  from  the  vegeta- 
ble kingdom. 

Caution  should  be  observed  in  adopting  the 
astringent  plan  of  treatment,  in  most  diseases.  In 
acute  inflammations,  in  all   affections   which   are 

9  «» 


130  ASTRINGENTS. 

accompanied  with  any  degree  of  fever,  or  even 
those  of  a  chronic  nature  attended  with  serious 
alteration  of  the  tissues,  medicines  of  the  astringent 
class  are  hkely  to  prove  injurious. 

Some  of  the  more  powerful  of  the  astringents, 
are  frequently  employed  locally,  for  the  purpose 
of  arresting  haemorrhages  ;  they  are  then  called 
Styptics. 

In  some  cases  where  astringents  are  indicated,  if 
irritabihty  exists.  Opium,  although  belonging  to 
the  division  narcotics,  may  be  administered  with 
great  advantage,  either  alone  or  combined  with 
some  more  immediate  astringent. 

A.S  the  most  convenient  preparation  of  Opiiun 
for  the  ready  formation  of  pills,  we  recommend  to 
practitioners  the  qffici7ial  mass  of  Dr.  Tully  : 

145. 

"Bf  Opii  Pulveris,     .     S  ss. 
Camphor93  Pulv.,    5j. 
Saponis  Alb.,      .     5  vij. 
Subige  in  massam,  divid.  equal,  in  pil.  ccxl. 

Each  of  the  above  pills  will  contain  one  grain  of 
opium. 

This  mass  will  remain  of  the  same  consistence 
for  a  great  length  of  time,  and  may  be  readily 
formed  into  pills  of  any  desired  size  ;    or  other 


ASTRINGENTS.  131 

medicinal  substances,  or  astringents,  can  be  most 
conveniently  combined  with  it. 

146. 

"E^  Pil.  Opii  Officinalis,  .     5  ss. 
Plumbi  Acetatis,  .     .     5j. 
Ipecac.  Pulv.,  .     .     .     gr.  xv. 
Fiat  massa  in  pil.  xxx.  divid.  cap.  unam  pro  re 
nata. 

These  pills,  administered  once  in  two  or  four 
hours,  according  to  circumstances,  are  useful  in 
haemoptysis,  and  other  internal  haemorrhages. 

147. 

^  Pil.  Opii  Officinalis,   5  ss. 
Argent.  Nitratis,  .     gr.  viij. 
Fiat  mass,  in   pil.  xxx.   divid.    quarum   sumat 
unam  terve  in  die. 

In  chronic  diarrhoea,  and  in  the  latter  stage  of 
dysentery,  the  above  pills  have  been  successfully 
employed  by  us  to  allay  the  irritation  of  the  intes- 
tinal membrane. 

In  active  haemorrhages,  the  subjoined  astringent 
pills  have  been  much  extolled  : 


132  ASTRINGENTS. 

148. 

^(  Plumbi  Acetatis,   5  ss. 
Digitalis,      .     .     3j. 
Opii  Pulv.,  .     .     gr.  V. 
Conserva3  Rosse,    5  ss. 
Fiat  massa  divide  in  pil.  xx.  et  exMbe  unam  ter 
quaterve  in  die. 

An  experienced  physician  of  this  city  has  em- 
ployed for  many  years  in  pulmonary  hagmorrhage 
the  following  astringent  mixture  : 

149. 

;^  Plumbi  Acetatis,   5j. 
Tinct.  Opii,       .     f.  5  ij. 
Aceti,      .     .     .     f.  5  V. 
Aquas  font.,       .     S  iij. 
Fiat  mistura,  cujus  capiat  cochl.  unum  parv.  pro 
re  natgt. 

This  mixture  is  declared  to  be  more  efficacious 
in  arresting  haemorrhage  from  the  lungs,  than  the 
Lead  and  Opium  are,  when  administered  in  the 
form  of  a  pill.  The  medicine  may  be  exhibited  in 
teaspoonful  doses  once  in  two  hours,  or  oftener  if 
required. 


ASTRINGENTS.  133 

150. 

;^  Plumbi  Acetatis,      5j. 
Tinct.  Opii,     .     .     f .  5  iss. 
Aquae  Cinnamom., 
Aquae  fontanse,  aa.  f.  5  ij. 
Fiat  mistura,  sumat  cochl.  parv.  ter  quaterve  in 
die. 

In  both  uterine  and  pubnonary  basmorrbage,  we 
can  recommend,  from  experience,  the  above  mix- 
ture as  a  most  excellent  remedy  ;  and  less  dis- 
agreeable tban  the  preceding  mixture. 

151. 

"Sji  Tinct.  Catecbu,  f.  5  iss. 
Aquae  Cinnam.,  f.  S  vss. 
Tinct.  Opii,    .     f.  5  ij. 
Syr.  Simp.,    .     f.  Sj. 
Fiat  mistura,  cujus  capiat  cochl.  mag.  pro  dosi. 

In  the  last  stage  of  dysentery,  or  in  protracted 
diarrhoea,  attended  with  profuse  evacuations,  the 
above  mixture  may  be  administered  after  each 
hquid  evacuation,  often  with  great  benefit. 

In  cases  of  incipient  ulceration  of  the  mucous 
membrane  of  the  iUiun  and  colon  which  so  often 
occurs  in  the  latter  stage  of  typhoid  fever,  and 


134  ASTRINGENTS. 

dysentery,  Prof.  N.  S.  Davis  is  accustomed  to 
recommend,  as  a  remedy  of  great  value,  the  fol- 
lowing : 

162. 

.^  Olei  Terebinth., 

Tinct.  Opii,  aa.      .     f.  5  ij. 
Acaciae  Pulv., 
Sach.  Alb.  Pulv.,  aa.   5  iij. 
Aqu88  Menth.  Pip.,     f.  S  ij. 
Fiat  mistura,  sumat  cochl.  parv.  tertia  vel  quarts 
quaque  hora. 

For  the   same  purpose  the  above  practitioner 
employs  the  following  pill : 


153. 

;^  Argenti  Nitratis,  gr.  viij. 
Opii  Pulv.,      .     3  j. 
M.  Et  in  pil  xx.  divid. 

In  persistent  chronic  diarrhoea,  the  following 
preparation  is  much  employed  by  Dr.  Ware,  of 
Boston : 


ASTRINGENTS.  135 

154. 

'^^  Cascarillae,        .     Sj. 
Cinnamonii,      .     5  ss. 
Gentianae, 

Nucis  Yomicae,  aa.  5  ij. 
Aquse  purae,      .     Oss. 
Fiat  infusio,  et  adde  Sach,  Alb.,  S  iv.  capiat  S  ss. 
vel  S  j.  pro  dosi. 

155. 

"Eji  Zinci  Sulphat.,     .     .     3  ij.  . 
Opii  Extracti,      .     .     gr.  x. 
Confectionis  Aromat.,   5  ss. 
Syrupi  q.  s.  ut  fiant  pil.  xl.  sumat  iinam  ter  in 
die. 

The  above  pills  may  be  employed  advantageously 
in  some  forms  of  chronic  bronchitis,  when  the 
expectoration  is  profuse.  They  are  also  a  valuable 
astringent  and  tonic  remedy  in  the  treatment  of 
leucorrhoea.  Under  the  same  circumstances  the 
following  pills,  if  preferred,  may  be  administered  : 

156. 

1^  Cupri  Sulphatis,  gr.  x. 
Opii  Extracti,  .  gr.  x. 
Confectionis  Rosae,  5  j. 


136  ASTRINGENTS. 

Fiat  massa  in  pil.  xxx.  div.  sumat  unam  ter  qua- 
terve  in  die. 

In  haemorrhage  from  the  kidneys  or  bladder,  or 
from  the  intestinal  mucous  membrane,  Tannic 
Acid  is  by  far  the  most  effectual  astringent  of  this 
class  of  remedial  agents. 

157. 

]^  Acidi  Tannici,     .     5j. 
Extracti  Gentian.,  9  ij. 
Misce  in  pil.  xx.  divide,  cap.  unam  tertiis  vel 
quartis  horis. 

Combiaed  with  Opium,  Tannic  Acid  is  often  suc- 
cessfully administered  in  the  treatment  of  uterine 
haemorrhage,  and  in  protracted  diarrhoea. 

158. 

Acidi  Tannici,     .     5  j.  ^ 

Extracti  Opii,     .     gr.  x. 
Conservae  Rosae,      5  ss. 
Fiat  massa  in  pil.  xxx.  divid.  sumat  unam  ter 
quaterve  in  die. 

In  uterine  haemorrhage  one  of  the  above  pills 
may  be  administered  every  hour. 


ASTRINGENTS.  137 

159. 

^  Decoc.  Uvae  Ursi,   5  iv. 
Acidi  Tannici,    .     5j. 
Tinct.  Opii,   .     .     f.  5  ij. 
Syr.  Acaciae,      .     S  ij. 
Fiat  mistura,  sumat  cochl.  parv.  ter  in  die,  vel 
saepius. 

In  albuminuria,  and  in  chronic  catarrh  of  the 
bladder,  the  above  astringent  mixture  is  a  most 
valuable  remedy. 

By  some  practitioners  the  Gallic  Acid  is  con- 
sidered preferable  to  Tannic  Acid,  inasmuch  as  the 
administration  of  the  latter  is  apt  to  be  followed 
by  constipation  of  the  bowels.  Gallic  Acid  is  said 
not  to  produce  this  effect.  The  following  mixture 
may  be  employed  : 

160. 

^      "^  Acidi  Gallici,      .     .     5  j. 
Mucil.  Acaciae, 
Syrupi  Aurantiae,  aa.  f.  5  ij. 
Aquae  fontansB,  .     .     f .  S  iv. 
Fiat  mistura,  cujus  sumat  conhl.  j.  mag.  ter  qua- 
terve  in  die. 

In  menorrhagia,  hematuria,  and  other  internal 


138  ASTRINGENTS. 

haemorrhages,  the  above  mixture  may  be  given 
with  great  advantage. 

The  following  preparation,  which  does  not  differ 
materially  from  the  above,  is  a  favorite  prescrip- 
ion  of  our   colleague,   Prof.   Barker,   lq  meno- 
•hagia. 

161. 

Tji  Acidi  GaUici, 

Acacise  Pulv.,  aa.     5  ij. 
Syrupi  Tolutan., 
Aquae  font.,  aa.    .     f  S  ij. 
Fiat  mistura,  sumat  cochl.  parv.  pro  dosi. 

Although  belonging  more  properly,  perhaps,  to 
the  class  narcotics,  we  shall,  under  the  head  of 
astringents,  speak  of  a  medicine,  which,  after  its 
employment  for  many  years,  not  only  by  ourselves, 
but  by  many  professional  friends,  we  can  confi- 
dently recommend  as  one  of  the  most  useful,  and, 
in  one  class  of  maladies,  the  most  certainly  reme- 
dial, of  any  of  our  therapeutical  agents. 

162. 

Tji  Tinct.  Camphorse,  .    f.  S  iss. 
Tinct.  Capsici,    .     .    f .  S  ss. 
Spiriti  Lavendul.  Co., 
Tinct.  Opii,  aa.  .     .    f.  S  j. 
Fiat  mistura,  capiat  m.  xx.  vel  xl.  pro  re  natS. 


ASTRINGENTS.  139 

Not  only  in  the  milder  forms  of  diarrhcea  have 
we  found  the  above  mixture  an  excellent  remedy, 
but  it  has  proved  in  our  experience,  most  valuable 
and  efficient  when  promptly  administered  on  the 
occurrence  of  the  "  premonitory  diarrhoea,"  in  the 
early  stage  of  epidemic  cholera. 

During  the  prevalence  of  the  cholera  in  this  city, 
in  1849,  and  again  in  1850,  we  administered  this 
mixture  in  a  large  number  of  cases  of  cholera,  in 
the  access  of  the  disease,  with  entire  success.  On 
the  occurrence  of  the  earhest  symptoms  of  the 
choleraic  diarrhoea,  it  should  be  given  in  doses  of 
from  thirty  to  sixty  drops,  every  hour  (or  oftener 
if  required),  confining  the  patient  strictly  to  a  hori- 
zontal position,  untn  all  tendency  to  the  diarrhoea 
is  entirely  overcome.  The  adoption  of  other  mea- 
sures will,  of  course,  be  required,  if  the  disease  is 
much  advanced. 

When  travelling  in  summer,  we  are  accustomed 
always  to  take  a  small  phial  of  the  above  mixture 
with  us  ;  as  this  medicine  is  quite  sure  to  arrest,  in 
children  or  adults,  the  intestinal  irritation  which, 
in  the  warm  season,  is  so  liable  to  follow  a  change 
of  diet  and  the  drinking  of  a  different,  and,  per- 
haps, a  harder  kind  of  water  than  that  to  which  we 
had  been  accustomed. 


CHAPTER   VII. 

DIAPHORETICS. 

Those  medicinal  agents  which  promote  or  in- 
crease the  insensible  transpiration  are  called  dia- 
phoretics. 

The  term  sudorijics  is  appHed  to  the  same  reme- 
dies when  they  produce  free  perspiration  or  sweat- 
ing. Diaphoretics,  which  operate  by  promoting 
diminished,  or  reestabhshing  suppressed  perspira- 
tion, are  important  agents  in  the  treatment  of  many 
forms  of  disease.  They  are  indicated  in  some 
varieties  of  febrile  disease  ;  in  chronic  cutaneous 
inflammations,  in  anasarca,  pulmonary  catarrh,  and 
in  rheumatic  and  gouty  affections. 

In  common  colds,  and  in  pulmonary  catarrhs, 
we  have  long  employed  the  following  mixture  with 
great  advantage  : 

163. 

"Bf  Liquor.  Ammonias  Acetatis,  £  Sij- 
Vini  Antimonii, 

Tinct.  Opii  Camph.,  aa.     .     f.  S  ss. 
Syrupi  Tolutan.,       .     .     .     f.  Sj. 
Fiat  mistura,  sumat  cochl.  parv.  bis  terve  in  die. 

140 


DIAPHORETICS.  141 

After  the  exiiibition  of  a  cathartic  in  a  severe 
cold,  or  in  influenza,  the  above  diaphoretic  mix- 
ture, administered  in  drachm  doses,  every  four 
or  six  hours,  we  have  found  to  be  a  most  valuable 
remedy. 

164. 

^t  Liquor.  Ammon.  Acetatis,  f.  S  ij. 
Misturae  Camphorae,   .     .    f .  5  iijss. 
Yini  Ipecacuanhge,      .     .    f.  5  ss. 
Syrupi  Tolutan.,     .     .     .    f.  S  ij. 
Fiat  mistura,  cujus   exhibe  cochl.  mag.  sextis 
horis  vel  saepius. 

In  the  commencement  of  fevers,  and  other  in- 
flammatory affections,  the  above  mixture  is  a  cool- 
ing and  highly  useful  diaphoretic. 

As  a  refrigerant  and  excellent  diaphoretic  in 
pneumonia,  and  in  the  commencement  of  febrile 
diseases,  the  following  is  employed  : 

165. 

^  Vini  Antimonii,     .     .     .    f.  S  ss. 
Potass.  Nitratis,     .     .     .     5  ij. 
Liquor.  Ammon.  Acetatis,  f.  S  ijss. 
Syrupi  Tolutan.,    .     .     .    f.  5j. 
Aqu33  purse,      ,     .     .     .    f.  S  iv. 


142  DIAPHORETICS. 

Fiat  mistura,  sumat.  cochl.  mod.  tertia  vel  quarta 
quaque  hora. 

In  the  commencement  of  fevers,  or  other  inflam- 
matory diseases,  when  it  is  desirable  to  obtain  a 
purgative  and  diaphoretic  effect,  the  subjoined 
mixture  may  be  advantageously  employed  : 

166. 

Tji  Magnes.  Sulph.,  .  f.  S  j. 
Ant.  et  Potass.  Tart.,  gr.  ss. 
Syrupi  Simp.,  .  .  f.  5  j. 
Aquse  Cinnam.,  .  f.  5  ij. 
Aquse  purse,  .  .  f.  S  v. 
Fiat  mistura,  sumat.  cochleare  unum  ampl.  omni 
hora. 

As  a  diaphoretic  and  alterative,  in  rheumatic  and 
other  inflammatory  afiections,  the  following  pills 
are  useful : 

167. 

T^  Pulvis  Antimonialis,   .    5  ss. 
Hydrarg.  Chlo.  Mite,      9j. 
Opii  Pulv.,    .     .     .     .    gr.  X. 
Conserv.  Rosae,       .     .    q.  s. 
Divide  in  pilulas  xx.  sumat  unam  quartis  horis. 


DIAPHORETICS.  143 

In  acute  rheumatism,  when  an  anodyne  diapho- 
retic is  indicated,  we  may  employ  the  following 
with  great  advantage  : 

168. 

]^  Potassae  Nitratis,     5  ij. 
Opii  Pulv.,     .     .    gr.  xii. 
Ipecacuanhae  Pulv.,  gr.  xviij. 
Fiant  pulv.  xii.  cujus  sumat  unam  hora  somni. 

When  a  still  more  powerful  diaphoretic  is  re- 
quired, as  in  the  treatment  of  dropsical  affections, 
and  in  the  early  stage  of  acute  bronchitis,  we  may 
have  recourse  to  the  following  pill : 

169. 

"E^  Pulvis  Ipecac,  Comp.,    .  5  j. 

Ant.  et  Potass.  Tart.,      .  gr.  iij. 

Hydrarg.  Chlorid.  Mite,,  gr.  xii. 

Mucil.  Acacioe,        .     .     .  q.  s. 

M.  Fiant  pil.  xii.  cujus  sumantur  ij.  mane  noc- 
teque. 

If,  after  taking  the  above  pills,  the  patient 
drink  plentifully  of  warm  fluids,  a  free  perspiration 
will  be  likely  to  ensue. 

In  the  commencement  of  fevers,  and  in  catarrhal 
affections,  attended  with  increased  vascular  action, 
the  following  is  a  useful  diaphoretic  : 


144  DIAPHORETICS. 

170. 

"Sji  Liquor.  Ammon.  Acetatis,  f.  S  ij. 
Spirit,  ^ther.  Nitrici, 
Vini  Antimonii,  aa.     .     .    f .  S  ss. 
Syrupi  Acacise,     ,.     .     .    f.  5j. 
Fiat  mistura,   cap.   cochl.   parv.   quaque  hor^^ 
Vel: 

171. 

!^  Ant.  et  Potass.  Tart.,  gr.  ijss. 
Aqug&  Cinnam.,       .     f.  S  ij. 
Syrupi  Simp.,     .     .     f .  S  ss. 
Aquae  puraB,       .     .     f .  S  iijss. 
Fiat  mist.,  cujus  sumat.  cochl.  parv.  secunda  vel 
tertia  hora. 

In  inflammatory  affections  of  the  respiratory 
organs,  such  as  pneumonia,  bronchitis,  croup,  etc., 
Prof.  Samuel  H.  Dickson,  of  Charleston,  adminis- 
ters the  following  with  advantage,  as  a  diaphoretic 
and  expectorant : 

172. 

IBji  Ipecacuan.  Pulv.,   .     .     5  j. 
Infus.  Pad.  Serpentaria,  5  vj. 
Tinct.  Opii  Camph.,    .     f.  5  ij. 
Fiat  mistura,  sumat.  cochl.  parv.  pro  '  *»  t""*^.. 


DIAPHORETICS.  145 

The  dose  may  be  varied  according  to  the  age  of 
the  patient  and  emergency  of  circumstances,  from 
one  drachm  to  half  an  ounce,  at  intervals  varying 
from  half  an  hour  to  two  hours. 

173. 

]^  PotassoB  Bi-Carb.,     9j. 
Tinct.  Opii  Camph.,  f.  5  ij. 
Aquae  Puree,    .     .     f .  S  viij. 
Fiat  mistura,  cap.  cochl.  ampl.  omni  bi  hora. 

The  above  is  recommended  by  the  same  dis- 
tinguished practitioner,  in  cases  of  fever,  with  (or 
without)  marked  gastric  irritabihty. 

174. 

^  Sod.  Carb.,       .     .     9  ij. 
Spts.  J^ther.  Nitrici, 
Syr,  Zingiberis, 
Aquae  purae,  aa.    .     f.  S  j. 

M.     Yel : 

175. 

^i  Potass.  Nitrat.,     .     .  5  iij. 

Ant.  et  Potass.  Tart.,  gr.j. 

Aquae  purae.,    .     .     .  5  iv. 

M.  Fiat  solutio.,  cujus  sumant.  cochl.  parv.  ij. 
eecunda  vel  tertia  horu. 

10 


146  DIAPHORETICS. 

Either  of  the  above  preparations,  says  Dr. 
Lindsley,  of  Washington,  may  be  administered  in 
fevers,  and  will  prove  efficient  and  valuable  reme- 
dies. 

"  The  following,"  writes  a  very  excellent  physi- 
cian, of  Massachusetts,  "  I  have  often  used  with 
very  happy  effect  in  scarlet  fever  : 

176. 

^  Ammon.  Carb.,    .     3iiss. 

Tinct.  Opii  Camph.,  f.  5  ij. 

Yini  Ipecacuanhas,    f.  5  ss. 

Aquae  purae,    .     .     f.  S  vj. 

Fiat  mistura,  sumat.  cochl.  mag.  quarta  vel  sextll 

quaque  hora." 

The  above  remedy  should  be  taken  in  the  fol- 
lowing way :  To  one  spoonful  of  the  mixture, 
add  two  ounces  of  water,  sweeten,  and  mix  with 
it  one  drachm  of  lemon  juice,  and  take  while 
effervescing. 


CHAPTER    VIII. 


DIURETICS. 


DiUEETics  are  a  class  of  remedies  which  have  the 
property  of  augmenting  the  secretion  of  urine. 

Some  diuretic  agents,  being  absorbed  by  the 
mucous  or  cutaneous  surfaces,  are  received  into 
the  circulation,  and  act  by  directly  stimulating  the 
kidneys  to  secrete  an  increased  quantity  of  urine. 
Other  remedies  of  this  class,  by  making  a  general 
impression  on  the  absorbent  system,  act  indirectly 
or  secondarily,  exercising  in  this  way  an  influence 
on  the  amoimt  of  urine  secreted. 

It  is  important  to  recollect  that  the  diuretic 
treatment  is  ordinarily  merely  secondary  ;  and  is 
not  generally  indicated  until  other  remedies,  which 
have  reference  to  the  primary  cause  of  the  disease, 
have  been  employed.  "Like  all  medicines  en- 
dowed with  special  properties,  diuretics  require 
two  conditions  to  produce  their  effects.  The  first 
is,  that  the  organ  into  which  they  are  introduced 
should  be  exempt  from  inflammation  ;  and  second- 
ly, that  the  organ  on  which  they  are  intended  to 


14T 


148  DIURETICS. 

act  after  being  absorbed,  should  be  a  healthy  one. 
Let  the  stomach  be  inflamed,  and  diuretics  will 
increase  the  inflammation  without  producing  the 
diuretic  efi"ect ;  or  let  the  kidney  be  inflamed,  and 
we  shall  only  inflame  it  still  more  without  increas- 
ing its  secretion."  * 

If  administered  on  an  empty  stomach,  and  fol- 
lowed by  gentle  exercise  in  the  open  air,  or  if  the 
surface  of  the  body  be  kept  cool,  diluent  drinks 
taken  freely,  the  operation  of  diuretics  will  be 
grer.tly  promoted. 


177. 


!^  Infus.  Juniperi,       .     S  vss. 
Spirit.  iEther.  Nitrici, 
Tinct.  Cinch.  Co.,  aa.   f.  S  j. 
•Tinct.  Cardamom.,       f.  5  ss. 
Fiat  mistura,  capiat  cochl.  mag.  ter  quarterve 
horis. 

The  above  diuretic  mixture  has  been  found  very 
beneficial  in  anasarca  attended  with  much  debility. 

When  it  is  desirable  to  promote  free  diuresis,  in 
cases  of  general  effusion  into  the  whole  cellular 
tissue,  the  subjoined  mixture  can  be  rehed  upon  as 
a  most  useful  diuretic  : 

*  Manual  of  Therapeutics,  p.  301. 


DIURETICS.  149 

178. 

]^  Infusi.  Digitalis,        .     .    f .  5  vi. 

Hydrarg.  Chlo.  Corrosiv.,  gr.  ij. 

Tinct.  Cantharid.,      .     .     f.  5  ij. 

Aqua8  Menth.  Pip.,  .     .     f .  S  ij. 

M.  Fiat  mistura,  sumat.  cochl.  mag.  bis  terve 

in  die. 

In  hydrothorax,  and  other  forms  of  dropsical 
effusions,  where  a  tonic  is  indicated,  the  follow- 
ing diuretic  combination  has  been  much  recom- 
mended : 


179. 

]^  Misturaa  Camphorae,    5  viiss. 
Spir.  ^ther.  Nitric,  f.  3  j. 
Tinct.  Digitalis,     .     f.  S  ss. 
Tinct.  Opii,        .     .     f .  5  ij. 
Tinct.  Columb.,      .     f.  S  j. 
M.  Fiat  mistura,  sumat.  cochl.  mag.  bis   quo- 
tidie. 

Should  a  still  more   powerful    diuretic  be  re- 
quired, the  subjoined  may  be  substituted  : 


150  DIURETICS. 

180. 

^i  Tinct.  Colchici,   .     .  .  f.  5  ss. 

Infus.  Juniperi,       .  .  f .  S  vi. 

Tinct.  Aurant.  Comp.,  f.  S  j. 

Potassse  Carb.,   .     .  .  5  ij. 

Potassae  Nitrat.,      .  .  5  j. 

M.  Fiat  mist.,  capiat  cochl.  larga  j.  vel  ij.  ter 
quaterve  in  die. 

In  the  treatment  of  the  different  forms  of  ana- 
sarca, but  particularly  in  that  which  arises  from 
diseased  heart,  we  have  employed  for  many  years, 
and  frequently  with  great  advantage,  the  follow- 
ing diuretic  combination : 

181. 

]^  Yini  Colchici,       .  f.  5  ij. 

.    .       Tinct.  Digitalis,    .  f.  5  vi. 

Potass.  lodid.,     .  5  iiss. 

Syr.  Sarsa.  Comp.,  f.  S  ij. 

Aqu£e  pur»,    .     .  f .  5  iij. 
M.  Fiat  mistura,  cujus  sumat.  cochl.  parv.  ter 
quaterve  in  die. 

By  some  practitioners  Elaterium  is  esteemed  a 
most  valuable  diuretic,  especially  in  anasarca  con- 
sequent  on  cardiac  disease. 


DIURETICS.  151 

182. 

^  Elaterii,     .     .     .     gr.  v. 
Digitalis  Pulv.,  .     gr.  xv. 
Extracti  Gentiange,  9  j. 
M.  Fiat  massa  et  div.  in  pilulas  xx.  quarum 
capiat  unam  mane  nocteque. 

183. 

"Eji  Aquae  Foeniculi  Dulcis,     f.  S  vi. 
Tinct.  Cantharid.,     .     .     f.  5  ij. 
Spirit,  ^ther.  Nitrici, 
Syrupi  Cort.  Aurant.,  aa.  f.  S  j. 
M.  Fiat  mistura,  sumat.  coch.  j.  amp.  pro  re  nata. 

The  above  mixture  is  a  very  pleasant,  and  quite 
an  active  diuretic. 

In  some  cases  of  anasarca,  where  the  disease  is 
attended  with,  or  proceeds  from  debility,  the  fol- 
lowing tonic  and  diuretic  may  be  exhibited  fre- 
quently with  great  advantage  : 

184. 

'^s  Tinct.  Cinch.  Comp.,     .     f.  S  iij. 

Tinct.  Cardamom.  Comp.,  f.  S  ij. 

Tinct.  Cantharid.,     .     .     f .  5  iij. 

Syr.  Acacioe,   .     .     .     .    f.  5j. 

M.  Fiat  mistura,  sumant.  cochlearia  duo  parv. 

ter  in  die. 


152  DIURETICS. 

With  some  practitioners,  the  subjoined  stimu- 
lant diurotic  is  a  favorite  remedy  in  general  ana- 
sarca attended  with  debility  : 

185. 

^f  Jimiperi  Fructi,    S  ij. 

Potass.  Nitrat.,      S  ss. 
Vini  Albi,     .     .     Oij. 
Macera  per  horas  duodecim  ;  sumant.  cochl.  duo 
ampl.  bis  terve  in  die. 


CHAPTER   IX 


ANTISPASMODICS. 


We  define  antispasmodics  to  be  medicines  which 
exert  a  direct  control  over  spasmodic  action  ;  or 
those  substances  wliich  counteract  irregular  or 
inordinate  muscular  action. 

It  is  doubted  by  some  therapeutists  whether  wo 
possess  any  medicinal  substances  which  do  act 
directly  on  the  muscular  fibre.  Those  agents 
which  are  ordinarily  arranged  in  the  class  anti- 
spasmodics are,  by  many,  believed  to  act  as  indi- 
rect agents,  relieving  spasmodic  action  by  revul- 
sion, or  through  the  influence  which  they  exert 
upon  other  parts  of  the  nervous  system  than  those 
concerned  in  the  muscular  contraction.  There  is, 
however,  a  class  of  medicinal  agents  which  exerts, 
unquestionably,  a  direct  control  over  spasmodic 
muscular  action.  We  have,  therefore,  both  direct 
and  indirect  antispasmodics. 

As  an  cfQcacious  remed}'',  in  the  treatment  of 
hysterical  affections,  and  in  subduing  great  ner- 
vous irritation,  we  may  administer  the  following 
antispasmodic  : 


158 


154  ANTISPASMODICS. 

186. 

^  Assafoetidae,  .     5  iss. 
Morph.  Sulph.,  gr.  v. 
Saponis  Dur.,      9  ij. 
M.  Fiat  massa  in  pil.  xl.  divide,  quarum  capiat 
unam  pro  re  nat^,  vel  binas,  hor^  somni. 

Should  a  more  stimulant  antispasmodic  be  re- 
quired, the  following  may  be  substituted  : 

187. 

"fy  Assafoetidae,  .     5j. 
Morph.  Sulph.,    gr.  iij. 
Camphorae  Pulv.,  3  ij. 
M.  Fiat  massa  et  in  pil.  xxx.  divide.     Sumat 
unam  ter  quaterve  in  die. 

Musk,  when  it  can  be  obtained  pure,  is  a  power- 
ful nervous  stimulant.  It  is  sometimes  given  in 
nervous  and  hysterical  affections,  in  combination 
with  other  antispasmodics. 

188. 

^  Moschi,    .     .     .     5j. 
Assafoetidae,      .     5  iss. 
Camphorae  Pulv.,  5  ss. 
Extracti  Gentianae,  q.  s. 
Ut  fiat  pil.  xxx.  quarum  capiat  unam  ter  in  die. 


ANTISPASMODICS.  155 

The  administration  of  musk  has  been  much  com- 
mended in  hiccough,  and  in  the  subsultus  of 
typhus  and  other  low  and  malignant  fevers. 

189. 

^  Moschi,      .     .  5j. 
jEther.  Sulph., 

Tinct.  Opii,  aa.  f.  5  iss. 

Aquse  Cinnam.,  f.  S  iiss. 

Syrupi  Simp.,  £^5iss. 
M.  Fiat  mistura,  de  qua  capiat  cochl.  j.  mag.  ter 
in  die. 

By  a  combination  of  two  or  more  of  the  anti- 
spasmodics, we  obtain  a  more  powerful  effect  in 
the  treatment  of  hysterical  and  other  nervous 
affections,  than  results,  ordinarily,  from  the  single 
administration  of  any  one  of  these  remedies. 

190. 

^  Tiucturge  Castori, 

Tinct.  Assafoetidae,  aa.  .  f.  5  iss. 

Aquae  Camphorge,    .     .  f.  Sj. 

Spirit.  Ammon.  Aromat.,  f.  5  ss. 

Syrupi  Acacia?,     .     .     .  f .  S  iss. 
M,  Fiat  mistura,  quarum  capiat  cochl.  j.  mag. 
pro  re  nata. 


156  ANTISPASMODICS. 

The  above  mixture,  given  in  doses  of  a  table- 
spoonful  every  hour  or  two,  has  been  recom- 
mended as  a  powerful  antispasmodic  in  hysteria. 

We  have  found  the  following  mixture  a  very 
useful  medicine  in  various  nervous  and  spasmodic 
diseases  : 

191. 

^  Tinct.  Castori,  .     f.  5  iss. 
Morph.  Sulph.,       gr.  iv. 
Tinct.  Valerianse,  f.  S  iss. 
Syrupi  Acacise,  .     f.  Sj. 
E.  Fiat  mistura,  sumat.  cochl.  j.  mod.  secundsi 
quaque  hora. 

In  spasm  of  the  stomach,  arising  from  jflatu- 
lence  ;  and  for  relieving  cardialgia,  the  subjoined 
mixture  will  be  found  very  efficacious  : 

192. 

^  Tinct.  Valerianse,  .  f.  S  j. 

Magnesiae  Carb.,    .  5  ij. 

Tinct.  Opii,  .     .     .  f.  5j. 

Aquse  Menth.  Pip.,  f.  S  iij. 

Olei  Anisi,    .     .     .  m.  xl.                • 

M.  Fiat  mistura,  cujus  capiat  cochl.  parv.  omni 
.\or£i,  vel  soepius.     Yel : 


ANTISPASMODICS.  157 

193. 

^  Tinct.  Lavendul.  Comp.,  f.  S  iss. 
Spirit.  Carui,      .     .     .     f.  5  ij. 
Tinct.  Opii,    .     .     .     .     f.  5j. 
^ther.  Sulph.,    .     .     .     f.  S  ss. 
Aqua3  font.,    .     .     .     .     f.  S  iv. 
M.  Fiat  mistura,  capiat  cochl.  j.  mag.  pro  re 
nata. 

The  Valerianate  of  Zinc  has  been  much  em- 
plo3^ed  by  some  practitioners,  by  whom  it  is 
recommended  as  a  valuable  tonic  and  antispas- 
modic, in  the  treatmeat  of  hysteria  and  other  ner- 
vous affections. 

194. 

I^  Zinci  Yalerianatis,    .  gr.  xii. 

Tincturse  Valerianae,  f.  S  ss. 

Aquae  Cinnam.,    .     .  f .  g  ij. 

Syrupi  Simp.,       .     .  f .  S  ss. 

Aquae  font.,     .     .     .  f.  S  iij. 

M.  Fiat  mistura,  cujus  capiat  semiunciam  sex- 
tis  horis. 

As  an  antispasmodic  in  the  treatment  of  chorea, 
the  Valerianate  of  Zinc  has  been  much  commended 
by  some  experienced  physicians.     In  combination 


158  ANTISPASMODICS. 

with  the  Subnitrate  of  Bismuth,  and  the  extract 
of  Hyoscyamus,  we  can  recommend  the  Valeria- 
nate of  Zinc  as  a  most  useful  remedy  not  only  in 
chorea,  but  in  neuralgia  and  other  nervous  dis-. 
eases. 

195. 

^t  Extract.  Hyoscyami,  9  ij. 
Zinci  Yalerianatis,  .    3  ij. 
Bismuth  Subnit.,     .    5j. 
M.  Fiat  massa,  et  in  pil.  xl.  div.,  quarum  capiat 
unam,  ter  quaterve  in  die. 

The  Valerianate  of  Ammonia  has  been  recom- 
mended, recently,  by  practitioners,  both  at  home 
and  abroad,  as  an  antispasmodic  in  hysteria,  but 
more  especially  in  the  treatment  of  facial  neural- 
gia. It  has  been  employed  by  Dr.  D eclat,  and 
some  other  foreign  practitioners,  with  great  suc- 
cess, in  the  treatment  of  nervous  diseases. 

Administered  in  doses  of  a  teaspoonful,  morning 
and  evening,  it  has  succeeded  in  controlling  neu- 
ralgic pains  after  all  the  ordinary  means  have  been 
tried,  in  succession,  without  avail.  If  pure,  it 
should  be  administered  in  diminished  doses  from 
those  recommended  by  Dr.  Declat. 

We  have  employed  the  following  mixture  in 
severe  facial  neuralgia : 


ANTISPASMODICS. 
196. 


;^  Ammon.  Yalerianatis,  f.  5  j. 
Syrupi  Tolutan.,      .    f.  5  j. 
M.  Sumat  cochl.  parv.  quartis  horis. 


159 


CHAPTER   X. 

ANTEELMINTICS. 

That  class  of  medicinal  agents  which  possesses 
the  property  of  destroying  worms,  or  of  expelling 
them  from  the  intestinal  canal,  is  called  anthel- 
mintics. The  principle  on  which  anthelmintics 
operate  is  not  the  same  with  all.  Some  b}^  their 
disagreeable  odor  destroy  or  dislodge  the  worms  ; 
others  b}-  mechanical  irritation  ;  and  others,  again, 
by  some  unknown,  specific  operation. 

In  selecting  these  remedies,  regard  should  be 
had  to  the  character  of  the  agent  employed,  and 
to  the  mode  of  application,  with  reference  to  the 
species  of  intestinal  worms  to  be  destroyed  or 
removed.  A  great  variety  of  animal  parasites 
have  been  found,  from  time  to  time,  in  the  human 
body.*     Of  those  whose  hahitat  is  the  alimentary 

*  A  very  valuable  work  on  the  "  Animal  and  Vegetable  Parasites  of  the 
Human  Body,"  by  Dr.  Friederich  Kuclienmcister,  of  Germany,  has  been, 
very  recently,  translated  and  published  by  the  Sydenham  Society.  It 
contains  ntuch  that  Is  new  and  interesting  on  this  subject,  and  adds  to  our 
inowlcdge  of  human  parasites. 
160 


ANTHELMINTICS.  161 

canal,  and  for  whose  removal  medicinal  agents  are 
frequently  required,  there  are  four  species  ;  the 
taenia  or  tape  worm,  the  trichuris  or  tricocephalus, 
ascaris  vermicularis,  and  ascaris  lumbricoides. 

The  preparations  of  Mercury  have  long  been 
employed  for  expelling  the  lumbrici  from  the 
intestinal  canal.  Calomel,  especially,  administered 
in  the  ordinary  purgative  doses,  has  proved  a  most 
efl&cient  anthelmintic  for  the  removal  of  the  round 
worm.  In  the  United  States,  the  Spigelia  Mari- 
landica  is  much  employed,  and  is  considered  one 
of  the  most  powerful  and  certain  of  the  anthel- 
mintics. 

197. 

1^  Spigelise  Mariland.,   5  ss. 
Aqua3  ferventis,    .    Oj. 
Macera  per  horam,  quarum  sumat  cochl.  mag. 
tertiis  vel  quartis  horis. 

If  a  moderate  dose  of  Calomel  be  given  in  the 
evening,  sufficient  to  produce  a  mild  cathartic 
effect,  and  its  operation  followed  the  next  day  by 
the  administration  of  the  infusion  of  Pinkroot,  in 
doses  of  from  half  a  fluid  ounce  to  a  fluid  ounce, 
once  in  three  or  four  hours,  we  have  found  this 
plan  altogether  more  efficient  than  when  the 
Spigelia  is  given  without  the  Calomel.     An  active 

11 


162  ANTHELMINTICS. 

dose  of  Castor  Oil  should  follow  the  last  dose  of 
Pinkroot. 

198. 

^  SpigelisB  Pulv  ,  5  iss. 
Stanni  Pulv.,       S  j. 
Syrupi  Simp.,  q.  s. 
M.  Fiat    electuarium,  cujus   sumat.  5j.   omni 
mane  nocteque. 

After  the  second  or  third  day  this  medicine 
should  be  followed  by  a  full  dose  of  Castor  Oil. 
The  above  combination  of  Spigelia  and  Tin  is  con- 
sidered, by  some  practitioners,  as  being  a  very 
powerful  and  efficacious  anthelmintic.  Kiichen- 
meister,  however,  protests  against  the  administra- 
tion of  tin-filings,  not  only  because  of  the  uncer- 
tainty of  the  remedy,  but  because  of  the  irritation 
of  the  intestinal  membrane,  excited  by  this  agent. 

It  is  advised  by  some  practitioners  to  unite  a 
purgative  with  the  Pinkroot. 

199. 

^i  Spigeli99  Mariland.,   5  ss. 
Senn83,   .     .     .     .     5  iij. 
Anisi,      .     .     .     .     5j. 
Aquae  ferventis,    .     Oj. 
Macera  per  horam,  sumant.  cochl.  ij.  ampla  ter- 
tiis  horis. 


ANTHELMINTICS.  163 

Dr.  A.  L.  Cox,  a  distinguished,  and,  for  many 
years,  a  successful  practitioner  in  tliis  city,  was 
accustomed  to  employ  the  following  anthelmintic : 

'  200. 

T^  Spigeliae  Mariland., 

Sennae,  aa.  .     .     .  S  ss. 

Potassae  Bitart.,    .  5j. 

Jalapse  Pulv.,        .  5  ss. 

Sem.  Cardamom.,  5  ss. 

Extract.  Glycyrrh.,  5  ij. 

Aquas  ferventis,     .  Oss. 
Macera  per  horam,  sumat.  cochl.  j.  vel  ij.  ampla, 
pro  re  nata. 

The  Filix  Mas,  or  Male  Fern,  although  a  foreign 
remedy,  has  been  much  employed  in  the  United 
States  as  a  vermifuge,  particularly  for  the  expul- 
sion of  the  tape  worm.  It  may  be  administered 
in  the  form  of  powder,  or  in  decoction. 

201. 

'^i  Filicis  Maris  Pulv.,   S  j. 
Syrupi  Simp.,  q.  s. 
M.  Fiat  electuarium,  cuj us  sumat  5j.   vel  5  ij. 
omni  mane  nocteque. 


164  ANTHELMINTICS. 

The  remedy  should  be  given  on  an  empty 
stomach,  and  after  being  continued  two  or  three 
days  should  be  followed  by  an  active  cathar- 
tic. 


202. 

"Ejs  Filicis  Maris,  .     S  j. 
Aquge  ferventis,  Oj. 
Macera  per  horam,   sumant.  cochl.  ij.  ampla, 
mane  ac  nocte. 

To  an  adult,  a  wineglassful  of  the  above  decoc- 
tion may  be  given,  fasting,  twice  or  thrice  daily  ; 
and  followed  by  a  cathartic  as  above. 

The  Kousso,  another  foreign  remedy,  has  also 
been  employed  by  American  practitioners  with 
considerable  success,  for  the  treatment  of  the  tape 
worm 

Kousso  is  the  flowers  of  a  plant,  the  Brayera 
Anthelmintica.  It  is  ordinarily  given  in  powder, 
and  should  be  administered  on  an  empty  stomach. 

It  will  prove  more  certainly  efficacious  if  pre- 
ceded by  a  cathartic. 


ANTHELMINTICS.  165 

203. 

"Sjt  Flo.  Brayerge  Anthelmint.,   S  ss. 
Aquse  tepidae,    ....     Oss. 
M.  Sumant.  S  ij.  omni  hora  quadrante. 

The  infusion  should  be  taken  in  divided  doses 
as  above,  on  an  empty  stomach.  After  a  few 
hours,  a  full  dose  of  Castor  Oil,  or  some  other 
brisk  cathartic,  should  be  administered. 

Prof.  Raimann,  of  Vienna,  has  been  quite  suc- 
cessful of  late  in  the  employment  of  Kousso,  exhi- 
bited after  the  following  manner :  An  infuso- 
decoction  is  made  by  macerating  5  vi.  of  Kousso 
for  twenty-four  hours  in  cold  water,  and  then 
boiled  for  half  an  hour.  It  is  then  taken  whilst 
fasting,  in  two  portions,  without  straining,  and  two 
hours  afterwards  from  one  to  two  ounces  of  Castor 
Oil.     This  remedy  acts  with  great  certainty.* 

Many  American  practitioners  consider  the  Oil 
of  Turpentine  the  best  anthelmintic  in  tinea. 
Large  doses  are  required  for  the  treatment  of  the 
tape  worm. 

204. 

T^  Olei  Terebinth.,    gj. 
Decoc.  Hordii,      S  ij. 
M,  Fiat  haustus. 

•  Euchemneister,  pp.  lGl-2. 


166  ANTHELMINTICS. 

After  repeating  this  dose  for  two  or  three  morn- 
ings, if  it  does  not  purge,  it  should  be  followed  by 
a  dose  of  Castor  Oil. 

Klichenmeister  likewise  regards  Oil  of  Turpen- 
tine one  of  the  best  and  most  energetic  remedies 
for  tape  worms.  He  advises  that  this  medicine 
be  administered  at  bed  time,  and  in  a  dose  of  one 
ounce  triturated  with  the  same  amount  of  Castor 
Oil  and  honey,  and  the  yolks  of  three  eggs.  It 
should  be  given  in  divided  doses,  and  all  in  the 
course  of  an  hour  or  an  hour  and  a  half. 

Under  the  name  of  Semen  Coutra,  the  East  has 
furnished  to  Europe  a  species  of  worm-seed,  which 
has  enjoyed  a  great  reputation  as  an  anthelmintic. 
It  has  seldom  been  used  in  this  country.  It  con- 
tains two  principles,  which  are  equally  efficacious, 
a  volatile  oil  and  Santonm.  This  latter  principle 
has  recently  been  introduced  into  this  country, 
and  is  especially  recommended  for  the  treatment 
of  worms  in  children,  on  account  of  its  want  of 
taste.  It  is  given  in  the  dose  of  from  a  half  a 
grain  to  three  grains,  twice  a  day.  An  agreeable 
form  for  children  is  the  sugar-coated  pills  of  Gar- 
nier,- Lamoureux  &  Co.,  which  contain  each  one 
half  of  a  grain,  and  invite  the  little  patient  by 
their  appearance  to  take  what  otherwise  he  would 
struggle  against.  The  dose  should  be  repeated 
for  several  days.     It  seldom  requires  a  cathartic, 


ANTHELMINTICS.  167 

as  it  acts  efficaciously  as  a  cathartic  in  the  larger 
doses. 

The  species  of  worm-seed  better  known  to  prac- 
titioners in  this  country  is  the  Chenopodium  An- 
thelmihticum.  It  is  reputed  for  its  expulsive 
powers  over  the  round  worm.  The  oil  is  a  favor- 
ite anthelmintic  in  some  of  the  dispensaries  of  this 
city.  In  this  form  the  Chenopodium  is  used  with 
much  success  by  one  of  my  friends,  Physician  to 
the  Children's  Department  of  the  Demilt  Dispen- 
sary. 

205. 

Bf  01.  Chenopodii,  gtt.  x. 
Syr.  Simp.,    .    f.  S  j. 
M.  Cochl.  parv.  ter  in  die. 

The  dose  should  be  continued  for  two  or 
three  days,  and  then  followed  up  by  a  brisk 
cathartic. 

To  dislodge  ascarides  of  the  rectum,  we  have 
employed,  successfully  an  enema  composed  of 
Olive  Oil.  From  four  to  six  ounces  of  the  oil 
should  be  administered  to  an  adult,  and  retained 
as  long  as  possible  in  the  rectum.  Young  children, 
who  often  sufier  greatly  from  the  presence  of 
ascarides  in  the  rectum,  are  frequently  promptly 


168  ANTHELMINTICS. 

relieved  by  the  employment  of  an  enema  com- 
posed of  two  ounces  of  Olive  Oil. 

In  the  treatment  of  this  troublesome  parasite, 
Trousseau  and  Pidoux  have  found  injections  of  the 
Biniodide  and  Bi-Chloride  of  Mercury  extremely 
effective.  To  an  adult  they  administer,  two  or 
three  days  successively,  an  enema  consisting  of  a 
quart  of  water  in  which  five  centigrammes  (about 
three-fourths  of  a  grain)  of  the  Biniodide  are  dis- 
solved by  means  of  one-tenth  of  Iodide  of  Potas- 
sium ;  or  they  employ  the  same  quantity  of  Corro- 
sive Sublimate  without  the  Iodide  of  Potassium. 
Injections  of  the  following  strength  may  be  used 
with  safety  : 

206. 

!^  Hydrarg.  Biniodid.,  gr.  j. 
Potass.  lodid.,      .     gr.  ss. 
Aquae  font.,     .    .     Oij. 
M.  Pro  enema. 


When  administered  to  children,  from  four  to 
six  ounces  of  this  solution  may  be  employed. 

These  authors  say  they  have  rarely  failed  of 
success  in  the  employment  of  either  of  the  above 
remedies. 


ANTHELMINTICS.  169 

They  advise  a  repetition  of  the  enemata  in  a 
fortnight  afterwards,  and  again  at  the  end  of  four 
or  five  weeks.* 

*  Trait6  de  Therapeutique 


CHAPTER   XI. 


EMMENAGOGUES. 


All  those  means  or  agents,  whether  external  or 
internal,  which  possess  the  power  of  stimulating 
the  generative  organs,  and  of  causing  a  determina- 
tion of  blood  to  the  uterus,  are  considered  emmena- 
gogues. 

In  therapeutics  the  term  is  restricted  to  those 
medicinal  agents  which  "  have  the  property  of 
promoting  or  restoring  the  menstrual  discharge." 

Before  employing  emmenagogues  we  should 
carefully  investigate  the  causes  which  tend  to 
obstruct  menstruation,  that  our  efforts  to  remove 
these  causes  may  be  intelligently  directed.  Sup- 
pression, or  absence  of  this  discharge,  is  generally 
dependent  upon  some  abnormal  conditions  of  the 
system  ;  or,  the  irregularity  may  be  the  effect  of 
debility  or  of  some  organic  disease  of  the  genera- 
tive organs  ;  therefore,  the  remedies  which  are  to 
be  employed  must  have  reference  to  these  varied 
causes. 

When  the  suppression  of  this  discharge  is  de- 
pendent upon    general   debility,   tonics  are  the 

170 


EMMENAG0GT7ES.  171 

appropriate  remedies  ;  and  of  these,  bark  and  the 
preparations  of  steel  are  the  most  efficacious. 
Occurring  in  persons  of  a  full  and  plethoric  habit, 
venesection,  or  other  antiphlogistic  measures  may 
be  required.  Under  other  circumstances  and  con- 
ditions, again,  amenorrhoea  may  be  successfully 
treated  with  active  purgatives,  or  with  stimulating 
diuretics  ;  and  sometimes  antispasmodics  are  the 
means  indicated.  Hence,  no  single  remedy,  nor 
only  one  plan  of  treatment  can  be  adopted  as 
being  applicable  to  all  cases. 

The  subjoined  medicinal  agents  belong  to  that 
class  of  remedies  which  experience  has  proved 
to  be  the  most  efficient  in  promoting  the  nienstrual 
discharge. 

207. 


^i  Ferri  Sulphatis,  . 

Siss. 

Potass.  lodid., 

5ij. 

Tinct.  Cardamom., 

Syr.  Simp.,  aa.     . 

f.sj. 

Aquae  font.,     .     . 

f-Sij. 

M.  Fiat  mist,  cujus  capiat  cochl.  parv.  ter  in  die. 

In  cases  of  suspended  menstruation,  attended 
with  headache,  and  with  pains  in  the  pelvic 
regions,  the  above  preparation  may  be  advan- 
tageously administered. 


172  EMMENAGOGUES. 

In  chlorotic  amenorrhoea  attended  with  debility, 
other  ferruginous  preparations  are  often  very  ser- 
viceable, particularly  when  combined  with  vegeta- 
ble tonics. 

208. 

"Eji  Ferri  Carb.,      .     5  iij. 
Tinct.  Columbae, 
Syr.  Zingiberi,  aa.  f.  S  ij. 
M.  Fiat  mistura  capiat  cochleare  parv.  mane  ae 
nocte.    Yel : 

209. 

Tjt  Ferri  Citrat.,    ...     5  ij. 
Syrupi  Aurantii, 
Aquae  Menth.  Pip.,  aa.  f.  S  ij. 
Aqug8  puraB,    .     .     .     f.  S  iv. 
Fiat  mistura,  de  qua  sumatur  cochl.  parv.  bis 
terve  in  die. 

"  There  is  one  formula,"  writes  Dr.  John  "Ware, 
"  I  have  used  for  many  years  in  chlorosis,  and 
think  it  the  most  satisfactory  remedy  in  this  dis- 
ease which  I  have  ever  employed.  I  mean  for 
cases  of  young  girls  with  pale  catamenia,  pale 
cheeks,  pale  lips — in  short,  paleness  everywhere  ; 
with  thin,  transparent  alabaster  fingers  and  ears, 


EMMENAGOGUES.  173 

short  breath,  palpitating  throbbings  in  head,  bruit 
du  diable,  etc.  etc.     Ecce  signum 

210. 
TJ6  Aloes, 

Ferri  Sulph.,  aa.     .     .     gr.  xvi. 
Hydrarg.  Chlorid.  Mitis,  gr.  iv. 
Fiat  massa  et  in  pil.  xvi.  div. 

"  Taken  twice  or  thrice  a  day  ;  the  quantity  of 
Aloes  to  be  varied  according  to  the  state  of  the 
bowels,  which  are  best  kept  moderately  relaxed — 
at  least  two  stools  a  day  if  this  can  be  borne.  The 
quantity  of  Calomel  also  to  be  varied,  if  necessary, 
and  the  mouth  carefully  watched. 

' '  I  know  of  hardly  any  combination  in  medicine 
so  sure  of  doing  its  duty." 

When  we  have  reason  to  suspect  the  obstruction 
to  depend  upon  a  rheumatic  condition  of  the 
womb,  the  greatest  benefit  may  be  anticipated 
from  the  exhibition  of  the  following  combination : 

211. 

^  Potass.  lodid.,  .     5  ij. 
Vini  Colch.,       .     f.  5iss. 
Syrupi  Sarsa., 
Aquae  font.,  aa.      f.  5  ij. 
M.  Fiat  mistura,  de  qua  capiat  cochl.  parv.  ter 
de  die. 


174  EMMENAGOGUES. 

In  connection  with  any  of  the  preceding  emme- 
nagogue  preparations  the  following  pills  may  be 
taken,  should  a  laxative  be  indicated  : 

212. 

^  Aloes  Pulv.,     .     5  iss. 
Ferri  Sulphatis,     9  ij. 
Myrrhas  Pulv.,      5  ij. 
M.    Fiat    massa,    in   pil.    xl.   divide  ;    quarum 
«umat.  j.-ij.  bis  quotidie. 

In  difficult  and  painful  menstruation,  attended 
with  a  torpid  condition  of  the  bowels,  the  follow- 
ing is  a  useful  remedy : 

213. 

"Eji  Decoc.  Aloes  Comp.,  S  iij. 

Sodge  Sub-boratis,  5  j. 
Tr.  Aloes  Comp., 

Tinct.  Castori,  aa.  .  f.  5  ss. 

Aquae  Cinnam.,       .  f.  5  ij. 
M.  Fiat  mistura,  capiat  cochl.  amplum  ter  in 
die. 

In  those  cases  of  dysmenorrhoea  which  are 
dependent  on  rheumatic  irritation  of  the  os  and 
cervix  uteri,  Prof.  Davis  is  accustomed  to  employ. 


EMMENAGOGUES.  175 

with   great   advantage,    the   following   combina- 
tion ; 

214. 

^  Vini  Colchici  Sem.,    .    .     S  j. 
Tinct.  Strammonii,    .     .     f .  S  ss. 
Tinct.  Cimicif.  Racemosse,  f.  Z  iss. 
M.  Fiat  mistura. 

"  Administered  during  the  interval,  Detween 
two  or  more  menstrual  periods,"  says  Dr.  Davis, 
"  in  doses  of  from  half  a  drachm  to  a  drachm, 
three  times  a  day,  it  will  often  completely  cure  ir 
the  above  cases." 

After  other  remedies  have  failed,  we  have  em- 
ployed successfully  the  following  mixture  for  the 
treatment  of  suppressed  menstruation  : 

215. 

^  Proto-Iodid.  Hydrarg.,  gr.  iij. 
Potass.  lodid.,      .     .     5  ij. 
Tinct.  Gentianae,  .     .     f  g  iij. 
Aquae  Cinnam.,    .     .     f  S  ij. 
Syr.  Simp.,      .     .     .     f.  gj. 
M.  Fiat  mistura,  cujus  capiat  cochl.  parv.  bis 
terve  in  die. 


176  EMMENAGOGUES. 

The  emmenagogue  recommended  and  employed 
by  Dr.  Dewees,  has  been  for  many  years,  among 
American  practitioners,  one  of  the  most  popular 
of  all  remedies  for  the  treatment  of  suppressed 
catamenia. 

The  following  are  the  directions  as  given  by 
Dr.  Dewees  :  * 

216. 

'Bji  Guaiaci  Pulv.,  .      .     .     g  iv. 

Sodee  Carb.,  vel  Potass,   5  iss. 

Pimentse  Pulv.,       .     .     S  j. 

Alcohol.  Officin.,     ,     .     Oj. 
Macera. 

Dr.  Dewees  directs,  that  the  volatile  spirits  of 
Ammonia  be  added  to  the  above  mixture,  after  it 
has  digested  for  a  few  days,  in  proportion  of  one 
or  two  drachms  to  each  four  ounces  of  the  tinc- 
ture ;  and  given  in  doses  of  a  teaspoonful  three 
times  a  day  in  a  glassful  of  sweetened  milk,  or 
wine. 

"  I  have,"  adds  he,  "  for  more  than  forty  years, 
almost  daily  used  this  medicine  in  suppressed 
catamenia,  and  more  especially  in  those  of  long 
standing,  without  its  having  failed  in  any  case 
proper  for  its  use." 

*  Treatment  oa  Dise&ses  of  Females,  pp.  123-4. 


CHAPTER   XII. 

GARGLES    AND    LOTIONS. 

Gargles  and  lotions  may,  with  propriety,  be 
arranged  together,  for  both  are  medicated,  local 
baths  ;  the  former  being  employed  as  washes  for 
the  mouth  and  fauces,  whilst  lotions  are  used  as 
washes  externally,  and  for  injections. 

In  affections  of  the  mucous  membrane  of  the 
mouth  and  throat,  gargles  are  only  serviceable 
when  the  disease  is  limited  to  the  fauces  and 
pharynx  ;  when  it  has  extended  into  the  larynx, 
or  even  into  the  sub-tonsillary  fossce,  these  parts 
are  not  reached  by  lotions  employed  as  gargles. 

As  a  gargle  in  inflammatory  sore  throat,  and  in 
the  early  stage  of  follicular  disease  of  the  throat, 
we  have  been  accustomed  to  employ  the  follow- 
ing : 

217. 

T^  Argent.  Nitratis,  3j. 

Aquae  Rosae,    .     f.  S  iv 

M.  Fiat  gargarisma. 

12  IT 


178  GARGLES   AND   LOTIONS. 

The  subjoined  may  also  be  used  under  the  same 
circumstances : 


218. 

^  Potassaa  Nitratis,  5  ij. 
Mellis  Rosa3,     .     S  j. 
Aquae  Rosae,     .    f.  S  v. 
M.  Fiat  gargarisma  saepe  utendum. 

In  chronic  inflammation  of  the  throat,  and  in 
the  latter  stage  of  follicular  disease  of  the  pha- 
ryugo-laryngeal  membrane,  we  have  often  derived 
great  benefit  from  the  frequent  use  of  the  follow- 
ing Creosote  gargle  : 


219. 

^  Creasoti, gtt.  xxiv. 

Tinct.  Myrrhae, 

Tinct.  Lavendul.,  Co.,  aa.  f.  S  ss. 
Syrupi  Simp.,      .     .     .    f.  5j. 
Aquae  font.,     .     .     .     .     f.  S  vi. 
M.  Fiat  gargarisma. 

Or  the  following : 


GARGLES   AND   LOTIONS.  179 

220. 

]^  Creasoti gtt.  xx. 

Tinct.  Capsici;     .     .     .  f.  5  ij. 

Tinct.  Myrrha3, 

Tinct.  Lavendul.  Co.,  aa.  f.  S  ss. 

Syr.  Simp S  j. 

Aquae  font.,   .     .     .     .  f.  S  vi. 
M.  Fiat  gargarisma. 

In  aphthous  affections  of  the  throat,  the  follow- 
ing is  an  excellent  gargle  : 

221. 


IBjt  Decoc.  Hordii,     . 

Svj. 

Mel.  Rosa3,      .     . 

Sj. 

Tinct.  Opii,     .     . 

f.  5  iss. 

Tinct.  Myrrhge,    . 

f.  5  vi. 

M.  Fiat  garg. 

Or  the  following,  which  has  been  highly  recom- 
mended in  ulcerated  sore  throat,  may  be  used : 

222. 

"^  Liquor.  Calcis  Chloridi,  f.  S  ss. 
Mellis  Rosae,      .     ,     .     5  j. 
Aqua3  font.,       .     .     .     f.  S  vss. 
M.  Fiat  gargarisma. 


180  GARGLES   AND   LOTIONS. 

As  a  most  excellent  detergent  lotion  in  venereal 
ulcerations  of  the  throat  and  fauces,  the  following 
may  be  frequently  employed  : 


223. 

]^  Hydrarg.  Chlorid.  Corrosiv.,  gr.  iij. 
Solve  in  Spirit.  Yin.  rect.,     5  ss. 
et  adde  Decoct.  Cinchon.,     .  f.  g  vj. 
Tinct.  Myrrhse,    .     .     .     .     f.  S  iv. 

Mellis  RosaB, S  iss. 

M.  Fiat  gargarisma. 

Young  children,  when  afifected  with  inflamma- 
tory sore  throat,  or  in  aphthous  affections  of  the 
throat,  are  often  much  relieved  by  using  frequently 
a  mild  wash  ;  the  following  may  be  employed  : 


224. 

^  Infus.  Rosa3,     .  S  vj. 

Tinct.  Myrrhse,  f.  S  ss. 

Mellis  commun.,  g  j. 
M.  Fiat  gargarisma. 

Or  the  following  may  be  substituted  when  a 
more  stimulating  gargle  is  Required  : 


GARGLES  AND  LOTIONS.  181 

225. 

^  Tinct.  Capsici,  .  f.  5  j. 

Aluminis,     .     .•  5j. 

Mellis  commun.  5  j. 

Aquae  purae,      ,  f.  5  ivss. 
Misce,  pro  gargarism. 

In  chronic  sore  throat,  attended  with  relaxation 
of  the  uvula,  the  following  astringent  gargle  is 
frequently  employed  : 

226. 

"S^  Decocti  Quercus,   S  vij. 
Aluminis,     .     .     5  ss. 
Yini  Gallici,     .     f.  S  j. 
M.  Fiat  gargarisma. 

The  above  is  also  a  useful  injection  in  leucor- 
rhoea,  or  in  ulceration  of  the  rectum  or  vagina. 

As  a  vaginal  injection  in  leucorrhoea,  the  follow- 
ing lotion  has  been  found  excellent : 

227. 

T^  Liquor.  Alumin.  Co., 

Aquae  font.,  aa.      .    f.  S  vj. 
...  ^ 

M.  Fiat  injectio. 


182  GARGLES   AND    LOTIONS. 

In  the  treatment  of  old  and  indolent  ulcers,  par- 
ticularly ulcers  of  the  leg,  we  have  employed,  for 
many  years,  the  following  stimulating  and  sedative 
lotion. 

228. 

^  Calcis  Chloridi,  5  j. 

Opii  Pulv.,     .  5  iss. 

Aquae  font.,   .  f.  S  vj. 
M.  Fiat  lotio  et  cola. 

By  applying  constantly  pledgets  of  lint,  wet 
with  the  above  wash,  to  old  and  troublesome 
ulcers,  they  have  been  healed,  frequently,  after 
other  applications  have  failed.  In  the  treatment 
of  chancre,  also,  after  cauterizing  the  ulcer,  it  is 
the  most  efficacious  remedy  that  can  be  employed. 
Frequently  applied  by  means  of  the  lint,  it  soon 
changes  the  character  of  the  sore,  and  arrests  the 
ulcerative  process.  The  employment  of  constitu- 
tional remedies,  however,  should  not  be  omitted. 


CHAPTER   XIII. 

ANTACIDS    AND     ANTILITHICS. 

Those  substances  which  are  capable  of  com- 
bining chemically  with  the  free  acid  that  is  often 
found  to  exist  in  the  stomach   and   primae  vise, 
and  of  neutralizing  it,  are  denominated  antacids. 
By  combining  with  the  acid  of  the  stomach  and 
digestive  organs,  a  new  innoxious  compound  is 
formed,  and  thus  a  temporary  paUiative  effect  is 
produced,  relieving  the  symptoms  caused  by  the 
presence  of  a  morbid  acidity.     The  employment 
of  antacids,  however,  do  not  serve  to  correct,  per- 
manently,   that  peculiar   state   of   the   digestive 
organs,  which  favors  the  formation  of  acids.     Their 
favorable  action  is  only  temporary  ;   their  pro- 
tracted use  not  mfrequently  serves  to  debilitate 
the  powers  of  the  stomach,  and,  therefore,  "  in  no 
case  should  their  administration  be  long  persisted 
in  without  occasional  interruptions." 

Where  the  acid  exists  in  the  stomach,  and  the 
upper  portion  of  the  intestinal  canal,  alkalies  of 
the  volatile  kind,  as  Ammonia  and  its  carbonate, 

ISS 


184  ANTACIDS   AND   ANTILITHICS. 

or  the  preparations  of  Magnesia  or  of  Lime,  should 
be  preferred.  If  the  acid  exists  in  the  urinary 
organs,  those  alkalies  which  have  a  tendency  to 
act  more  directly  on  the  kidneys,  as  the  prepara- 
tions of  Potash,  Magnesia  and  its  salts,  should  be 
employed. 

In  cases  of  headache  arising  from  acidity  of  the 
stomach  and  primse  vise,  the  subjoined  has  been 
most  efficacious  in  many  instances  : 

229. 

^  Sp.  Ammon.  Aromat.,  f.  5  vj. 
Sodae  Bi-Carb.,    .     .     5  iss. 
Infus.  Cascarillse,      .     f.  5  viiss. 
M.  Fiat  mistura,  cujus  capiat  cochl.  ampl.  ij. 
bis  in  die,  ante  cibum. 

In  gastrodynia,  and  in  other  gastric  and  intes- 
tinal disturbances,  the  following  is  an  elegant  and 
invaluable  mixture  : 

230. 

Tji  Sodse  Subcarb.,     .     .     5  iss. 

Aquae  purae,     .     .     .     Oj. 

Acidi  Sulp.  dilut.,      .    f.  5j. 

Confectionis  Aromat., 

Aquae  Menth.  Pip.,  aa.  f.  5  ss. 
M.  Fiat  mistura,  cap.  cochl.  ij.  mag.  bis  in  die. 
Or  the  following : 


ANTACIDS   AND  ANTILITHICS.  185 

231. 

^  Liquor.  Calcis.,    .     .     .     f .  S  viiss. 
Magnesias  Calcin.,    .     .     5  ss. 
Spirit.  Ammon.  Aromat.,  f.  5  iij. 
Tinct.  Card,  comp.,  .     .     f.  5  j. 
M.  Sumat.  cochl.  ij.  larga  bi»  die,  vel  saepius. 

In  heartburn  and  other  cases  of  acidity  of  the 
stomach  and  primae  vias,  the  carminative  mixture 
first  recommended  by  Dr.  Meigs,  is  much  em- 
ployed, and  often  with  great  advantage  : 


232. 

"Sji  Magnesiae  Carb.,       .     5  ss. 
Magnesiae  Sulph.,     .      5  iiss. 
Sp.  Ammon.  Aromat.,  f.  5  j. 
Tinct.  Rhei,    .     .     .     f.  5  ss. 
Tinct.  Hyos.,  .     .     .     f.  5  ss. 
Aquae  Menth.,     .     .     f .  S  iv. 
M.  Fiat  mistura,  cujus  sumat  cochl.  unara  mag. 
bis  terve  in  die. 

In  chronic  diarrhoea  depending  on  a  redundancy 
of  acid  in  the  stomach  and  intestines,  the  follow- 
ing will  be  found  useful : 


186  ANTACIDS   AND   ANTILITHICS. 

233. 

^  Mistur.  Creta3,     .     f.  S  vj. 
Spirit.  Cinnam.,  .     f.  S  iss. 
Aquse  Ammon.,  .     fSiss. 
Tinct.  Opii,     .     .     gtt.  1. 
M.  Fiat  mist,  sumat  cochl.  j.  vel  ij.  ampl.  pro 
re  nat^. 

The  carminative  mixture  of  Dr.  Dewees  has 
been  extensively  employed  in  this  country  in 
acidity,  flatulent  colic,  diarrhoea,  etc.,  of  young 
children.     It  is  an  excellent  remedy  : 


234. 

lEji  Magnes.  Carb,,   .     5  j. 
Tinct.  Assafoetidae,  f.  5  ss. 
Tinct.  Opii,    .     .     gtt.  xl. 
Sach.  Alb.,     .    .     5  ij. 
Aquae  purse,  .     .    f.  S  ij. 
M.  Fiat  mistura,  date  m.  xx.  vel  xxx.,  pro  re 
nata. 


My  colleague,  Prof.  Davis,  highly  recommends, 
under  the  same  circumstances,  the  following  : 


ANTACIDS  AND  ANTILITHICS.  187 

235. 

^  Cretaa  prep., 

Sach.  Alb.,  aa.  .     5  j. 
Acaciae  Pulv.,  .     5  ij. 
Aquas  Cinnam.,     f.  S  iv. 
M.  Sumat.  cochl.  parv.  bis  terve  in  die. 

In  the  treatment  of  the  lithic  acid  diathesis,  the 
alkaline  bi-carbonates  are  the  appropriate  reme- 
dies. Their  exhibition  should  be  preceded  or 
accompanied  by  counter-irritation  over  the  lum- 
bar region,  and,  if  indicated,  active  purgation. 


236. 

^  Aquae  Ammon,  Carbonatis,  f.  S  j. 
Infus.  Gentianas  Co.,  .  .  f.  g  v. 
Sp.  ^therei  Nitrosi,   .     .     f .  S  ss. 

Aq.  Cinnam. f .  g  iss. 

M.  Fiat  mistura,  de  qu^  sumat.  cochl.  j.  vel  ij., 
upl.  ter  in  die. 

In  those  cases  where  the  urine  indicates  the 
presence  of  lithic  acid,  the  above  mixture  may  be 
employed  with  advantage.     Or  the  following : 


188  ANTACIDS   AND   ANTILITHICS. 

237. 

^  Liquor.  Potassae,  .     f.  S  ss. 

Tiuct.  Humuli,      .    f.  S  iss. 

Infusi  Columbse,    .     f.  S  iv. 

Syr.  Aurantiae,       .     f.  5  ij. 

Fiat  mistura,  capiat  cochl.  larga  unam  "bis  terve 

in  die. 

In  the  arthritic  or  rheumatic  diathesis,  in  which 
a  tendency  to  the  morbid  formation  of  lactic  acid 
may  exist,  we  have  employed,  advantageously, 
the  following  : 

238. 

Tji  Potassse  lodid.,  .     5  iij. 
Liquor.  Potass.,       f.  5  iiss. 
Tinct.  Colchici,  .     f.  5  ij. 
Tinct.  Cardamomi,  f.  S  ij. 
Syr.  Sarsa.,    .     .    f .  S  iv. 
M.  Fiat  mistura,  cujus  capiat  cochl.  parv.  ter  in 
die. 

The  Potassio-Tartrate  of  Soda,  in  combination 
with  the  wine  of  Colchicum  and  an  anodyne,  is 
the  great  remedy  on  which  Dr.  Fuller,  of  St. 
George's  Hospital,  London,  depends,  in  the  treat- 
ment of  acute,  rheumatic  affections.  He  adminis- 
ters these  remedies  in  a  simple  saline  or  a  nitre 
draught,  as  the  following  : 


ANTACIDS   AND  ANTILITHICS.  189 

239. 

I^  Haustus  Salini,    .     .     .  f .  S  iss. 

Sodae  Potassio  Tartratis,  3  ij. 

Yini  Colchici,      .     .     .  gtt.  xv. 

Tinct.  Opii,     ....  gtt.  vij. 
M.  Fiat  haustus. 

**  This  draught  is  repeated,"  says  Dr.  Fuller, 
"  for  the  first  twelve  or  twenty-four  hours,  at 
intervals  of  three  or  four  hours,  according  to  the 
strength  of  the  patient  and  the  severity  of  the 
attack."  * 

*  Dr.  H.  W.  Fuller,  •  On  Rheumatism,  Rheumatic  Gout,"  etc.,  p.  99. 


CHAPTER   XIT 

DERIVATIVES  OR  COUNTER-IRRITANTS,  OINTMENTS,  ETC. 

Derivative  remedies  are  often  of  the  highest 
importance  in  the  treatment  of  disease. 

The  revulsive  method  is  employed  when  we 
wish  to  remove  or  relieve  a  diseased  condition  of 
some  internal  organ  or  part,  by  producing  a  new 
irritation  on  the  surface  of  the  body,  or  determina- 
tion to  some  part,  remote  from  the  disease. 

In  the  employment  of  derivatives,  we  should 
have  regard  to  the  condition  of  the  system,  and 
the  character  and  degree  of  inflammation  present. 

"  That  state  of  the  system,  usually  called  irrita- 
ble, seldom  admits  of  revulsive  action,  the  seconda- 
ry disorder  so  induced  frequently  reacting  on  the 
primary."*  When  any  internal  organ  is  the  seat 
of  active  inflammation,  as  the  lungs,  for  instance, 
powerful  derivatives  should  not  be  applied  until 
vascular  excitement  has  been  reduced  by  general 
measures.     Counter-irritation  is  of  the  most  value 

*  Manual  cf  Therapeut.,  p.  834. 
ISO 


DERIVATIVES,    OR  191 

in  the  treatment  of  obstinate  chronic  disease  ;  in 
local  congestions,  and  irritations  of  important 
internal  organs.  The  principal  agents  employed 
as  derivatives,  in  the  practice  of  medicine,  are 
rubefacients,  vesicants,  pustular  counter-irritants, 
and  issues  or  setons. 

The  following  rubefacient  liniment  is  strongly 
recommended  by  an  experienced  physician,  by 
whom  it  has  been  employed  for  many  years,  in 
the  treatment  of  intercostal  rheumatism,  and  other 
rheumatic  pains  of  the  chest  and  back  : 

240. 

Tjf  Olei  Origani, 

Olei  Terebinth.,  aa.  S  ss. 
Tinct.  Opii, 
Aquae  Ammoniae, 
Olei  Olivae,  aa.     .         g  j. 
M.  Fiat  linimentum. 

A  very  celebrated  "  Rheumatic  Liniment,"  was 
extensively  sold  in  New  England,  several  years 
ago,  as  a  patented  medicine,  the  formula  for  which 
was  pirated  from  an  American  medical  journal, 
published  nearly  thirty  years  ago.  It  was  first 
recommended  by  an  able  physician,  for  the  treat- 
ment of  rheumatic  affections  of  the  joints. 

The  following  is  the  formula  : 


192         COUNTER-IRRITANTS,    OINTMENTS,    ETC. 

241. 

^  Olei  Origani, 
Aquae  Ammoniae, 
Tinct.  Opii, 
Olei  Olivae,  aa.  .     g  j. 
M.  Fiat  liniment. 

This  liniment  should  be  applied  and  followed 
by  frictions  with  the  hand  ;  or,  pieces  of  cotton  or 
flannel,  wetted  with  the  liniment,  may  be  laid 
over  the  inflamed  joint,  and  evaporation  pre- 
vented by  covering  the  whole  with  oiled  silk. 

In  rheumatic  and  neuralgic  afi'ections,  the  fol- 
lowing liniment  is  recommended  by  Prof.  Cox  : 

242. 

^  Olei  Origani, 

Tinct.  Camphorae,  aa.  f.  g  ss. 

Granville's  Lotion,  .  f.  5  iij. 

Chloroformi,    ...  3  iijss. 
Tinct.  Aconiti, 

Tinct.  Capsici,  aa.     .  f.  g  ss. 

01.  Sassafras.,       .     .  5  ss. 

Lin.  Sapon.  Comp.,  .  g  j. 
M.  Fiat  Liniment. 

In  the  treatment  of  incipient  sore  throat,  and 
in  various  pains  and  aches,  we  have  derived  great 


DERIVATIVES,    OR  193 

advantage  from  the  use  of  the  following,  employed 
as  a  liniment,  with  cutaneous  frictions  : 

243. 

^  Tinct.  Arnicae, 

AquaB  AmmoniaB,  aa.  f.  S  j. 
Spirit.  Camphorae, 
Tinct.  Opii,  aa.  .     .    f .  S  ss. 
OleiOIivae,    .     .     .     f.  gj. 
M.  Fiat  linimentum. 

To  relieve  neuralgic  or  rheumatic  pains,  the 
following  has  often  proved  very  serviceable  : 

244. 

^  Tinct.  Aconiti, 
Tinct.  Opii, 
Tinct.  Camphorse, 
Chloroformi,  aa.      S  ss. 
Misce  pro  liniment. 

As  a  stimulating  anodyne  embrocation,  the  fol- 
lowing is  much  employed  by  an  eminent  physician 
of  Philadelphia : 

245. 

^  Liniment.  Saponis,   S  iij, 
Chloroformi,    .    .     jj. 
M.  Fiat  Liniment. 

13 


194         COUNTER-IRRITANTS,    OINTMENTS,    ETC. 

Prof.  Harvey  Lindsly  recommends  the  following 
,as  a  valuable  anodyne  liniment : 


246. 

"Sjf  CamplioraB,      .    5  v. 
Chloroformi,  vel, 
01.  Terebinth,      S  j. 
Tinct.  Opii, 
01.  Olivse,  aa.       Sj. 
M.  Fiat  liniment. 

All  active  rubefacients  may  become  vesicants,  if 
applied  for  a  sufficient  length  of  time.  The  nature 
and  use  of  vesicating  agents  proper,  are  well 
understood. 

Among  counter-irritants,  tartar- emetic  is  the 
principal  agent.  It  is  the  most  certain  of  all 
means  for  exciting  pustular  counter-irritation ; 
and  pustular  inflammation,  long-continued,  is  alto- 
gether more  effective  than  vesication,  in  the  treat- 
ment of  chronic  bronchitis,  parenchymatous  inflam- 
mation, and,  indeed,  in  most  forms  of  deep-seated, 
thoracic  disease. 

The  following  ointment  may  be  employed  when 
we  wish  to  insure  full,  pustular  counter-irritation  : 


DERIVATIVES,    OR  195 

247. 

^  Antim.  et  Potass.  Tart.,  5  ij. 

Camphorae  Pulv.,    .     .  5  ss. 

Adipis  Preparat.,    .     .  gj. 
M.  Fiat  unguentum. 

If  the  part,  to  which  the  ointment  is  to  be 
applied,  be  first  wet  with  strong  vinegar,  or 
stimulated  by  friction,  the  effect  will  be  more  cer- 
tain and  uniform. 

If  a  milder  efifect  be  desired,  we  may  employ 
the  following  : 

248. 

'Bf  Ant.  et  Potass.  Tart.,      .  5  iss. 

Ipecac.  Pulv.,  .     .     .     .  5j. 

Cerati  Simp.,  vel  Adipis,  S  j. 
M.  Fiat  unguent. 


•&' 


In  acute  inflammation  of  the  lungs  and  air-pas- 
sages, where  vesication  would  be  improper  before 
vascular  action  is  reduced,  we  have  advised  for 
many  years  the  employment  of  a  saturated  aqueous 
solution  of  Emetic-tartar.  After  friction,  as  for 
the  ointment,  the  solution  should  be  rubbed  on 
gently  with  a  piece  of  soft  flannel  ;  and  should  be 
applied  as  hot  as  the  skin  can  bear  it.  A  full  and 
uniform  eruption  is  thus  speedily  produced  which 


196         COUNTER-IRRITANTS,    OINTMENTS,    ETC. 

proves  a  very  valuable  counter-irritant,  in  these 
affections. 

Or  a  liniment  may  be  formed  of  equal  efficacy. 


249. 

^  Solutio.  Ant.  et  Potass.  Tart,  saturat.,  5  iss. 

Potass.  lodid., 5  j. 

Olei  Terebinth  vel  OlivaB,    .     .     .     .  5  ss. 
M.  Fiat  liniment. 


250. 

IJj  Ant.  et  Potass.  Tart.,   5  ss. 
Olei  Tiglii,     .     .     .     gtt.  xx. 
Ipecac.  Pulv.,     .     .     5  j. 
Unguent.  RosaB,      .     S  j. 
M.  Fiant  unguent. 

The  above  ointment  is  a  mild  and  very  elegant 
counter-irritant ;  one  which  we  have  long  em- 
ployed when  a  revulsive  has  been  indicated  in  the 
treatment  of  diseases  in  delicate  females  and  young 
children. 

One  equally  mild  is  recommended  by  a  physi- 
cian from  a  neighboring  city,  as  a  valuable  coun- 
ter-irritant. 


DERIVATIVES,    OR  I9t 

251. 

]?»  Olei  Tiglii,     .     .     .     5j. 
Liniment.  Saponis  Co.,  S  j. 
M.  Fiat  liniment. 

Or  the  following  may  be  employed  : 

252. 

Tft  Olei  Tiglii,  .     gtt.  xxx. 
^ther.  Sulph.,  Sj. 
M.  Fiat  mistura. 

As  a  derivative  in  the  treatment  of  tuberculosis, 
we  have  employed  extensively  the  following  mild 
counter-irritant.  It  is  a  very  valuable  external 
remedy  : 

253. 

!^<  Potass.  lodid.,     .     .     5  j. 
Proto-Iodid.Hydrarg.,  gr.  x. 
Unguent.  Rosae,  .     .     S  j. 
M.  Fiat  unguent. 

A  portion  of  this  ointment  should  be  applied 
to  the  part  of  the  chest  over  the  diseased  lung, 
night  and  morning,  and  be  rubbed  in  by  friction 
with  the  hand. 

A  distinguished  French  practitioner  recommends 


108         COUNTER-IRRITANTS,    OINTMENTS,    ETC. 

the  following  ointment   to   be   employed  in   the 
^same  way,  and  for  the  above  disease  : 

254. 

]^  lodinii,    .     .     .  .     gr.  xii. 

Potass.  lodid.,  .     5  j. 
Adipis  preparat.,        S  j. 
M.  Fiat  unguent. 

The  method  of  establishing  setons  and  issues, 
and  their  effects  as  counter-irritants,  are  well 
understood. 

Under  the  head  of  unguents,  we  shall  speak  of 
some  valuable  remedial  agents  which  are  not 
properly  classed  among  the  derivatives. 

Ointment  for  haemorrhoids. 

255. 

]^  Unguent.  Stramonii,  .  gj. 

Plumbi  Carb.  Pulv.,  .  5  j. 

Opii  Pulv.,   ....  5  iss 
M.  Fiat  unguent. 

In  the  treatment  of  haemorrhoids,  we  have  long 
employed  the  above  ointment,  and  in  many  cases 
with  entire  success. 

A  more  stimulating  and  astringent  ointment  is 


DERIVATIVES,    OR  199 

much  commended  by  an  old  practitioner  of  this 
city. 

256. 

"Bjt  Unguent.  Stramonii,  .  Sj. 

Gallffi  Pulv.  intim.,     .  5  j. 

Camphori  Pulv.,    .     .  5  ij. 
M.  Fiat  unguent. 

The  following  is  much  employed  by  foreign 
physicians  : 

257. 

^  Gallse  Pulv.,     .     .     5j. 
Opii  Pulv.,  ...     5  ij. 
Liq.  Plumbi  Ace  tat.,  f.  5  ij. 
Adipis  preparat., 
Cerati  Cetacei,  aa.      S  j. 
M.  Fiat  unguent. 

In  discussing  scrofulous,  and  other  indolent 
tumors,  we  have  derived  great  advantage  from  the 
use  of  the  subjoined  ointment : 

258. 

^  Proto-Iod.  Hydrarg.,  gr.  x. 
Potass.  lodid.,   .     .     5  j. 
Cerati  Simp.,     .     .     5j. 
M.  Fiat  unguent. 


200         COUNTER-IREITANTS,    OINTMENTS,    ETC. 

As  an  external  application  in  the  treatment  of 
neuralgia,  the  following  ointment  is  declared,  by 
an  experienced  practitioner,  to  be  almost  infallible  ; 
it  should  be  rubbed  over  the  painful  part  once  or 
twice  a  day.    It  is  a  powerful  application  : 


259. 

Ty  Yeratrise,  gr.  v. 
Adipis,  .    5j. 
M.  Fiat  unguent. 

The  venerable  Dr.  Boyd,  of  this  city,  was  accus- 
tomed, for  many  years,  to  use  an  ointment  of 
Veratrine  in  the  commencement  of  nervous  deaf- 
ness. 

260. 

Tji  Veratriae,    .     .    9j. 
Unguent.  Rosse,    S  j. 
Misce  pro  unguento. 

A  small  portion  of  the  above  ointment  should 
be  applied  night  and  morning,  with  friction  behind 
the  affected  ear. 

As  an  external  application  in  eczema,  and  some 
other  forms  of  obstinate  cutaneous  disease,  the 


DERIVATIVES,    OR  201 

following  ointment  is  recommended  by  our  col- 
league, Prof.  Carnochan  : 

The   internal   administration   of  the  Arsenical 
solution  is  advised  at  the  same  time. 


261. 

^  Olei  Tabac,       .     .     .  gtt.  vj. 

Hydrarg.  Praecip.  Alb.,  9  j. 

Cerati  Simp.,     .     .     .  S  j. 
M.  Fiat  unguent. 

In  the  treatment  of  chronic  inflammation  of  the 
eyes,  particularly  in  ophthalmia  tarsi,  the  follow- 
ing we  have  found  to  be  an  invaluable  remedy : 

262. 

^  Hydrarg.  Oxydi  Rubri,  gr.  v. 
Cerati  Simp.,    .     .     .     S  ss. 
M.  Fiat  unguent. 

A  small  portion  of  the  ointment  should  be 
applied  at  night,  along  the  borders  of  the  eyelids. 

As  a  highly  useful  lotion  in  ophthalmia,  the  fol- 
lowing is  recommended  by  Prof.  Cox,  of  Mary- 
land : 


202        COUNTER-IRRITANTS,    OINTMENTS,    ETC. 

263. 

"Sji  Hydrarg.  Oxydi  Mur.,  gr.  j. 
Mucil.  Sassafras.,      .     5  ij. 
Villi  Opii  (Sydn.)     .     f.  5  ij. 
Aquae  Rosae,  .     .     .     f .  S  viij. 
M.  Fiat  lotio. 

In  a  communication  from  Dr.  Porcher  of 
Charleston,  containing  several  valuable  formulae, 
that  experienced  practitioner  writes  :  "  As  a  Col- 
ly rium  in  simple  inflammation  of  the  conjunctiva, 
as  well  as  in  pustular  inflammation  of  that  mem- 
brane, I  have  found  no  lotion  so  good,  as  com- 
mon vinegar — one  drachm  to  two  ounces  of  water. 
A  few  drops  to  be  inserted  into  the  eye,  three 
times  a  day,  and  a  cloth  wet  with  it,  should  be 
placed,  at  the  same  time,  over  the  closed  eyelids. 
It  is  far  superior  to  Acetic  Acid,  diluted,  for  the 
vinegar  contains  a  mucilage  which  has  a  soothing 
influence  on  the  inflamed  membrane." 


THE  END. 


TOXICOLOGICAL   TABLE: 

Exhibiting  the  Syrnptoms  of  Poisoning,  the  Antidotes 
for  each  Poison,  and  the  Tests  projper  for  their  De- 
tection. 

GENERAL   SYMPTOMS   OF   POISONING. 

When  a  person  in  perfect  health  is  suddenly  attacked, 
after  having  taken  food  or  drink,  with  violent  pain, 
cramp  in  the  stomach,  nausea,  vomiting,  convulsive 
actions,  and  a  sense  of  suffocation ;  or  when,  under  the 
same  circumstances,  he  is  seized  with  vertigo,  delirium, 
or  unusual  drowsiness,  there  is  every  reason  to  suspect 
that  he  has  taken  poison. 

Poisoning  may  be  distinguished  from  a  sudden  fit  of 
apoplexy  by  the  stomach  and  throat  not  being  affected 
in  the  latter. 

In  all  cases  of  poisoning,  employ  the  stomach  pump  as 
promptly  as  possible. 


ACIDS. 

Citric      Acid. 
Muriatic      " 
Citric  " 

Sulphuric    " 
Oxalic  " 


SYMPTOMS. 


The  mouth  and 
throat  has  a  severe 
sense  of  burning;  the 
taste  sour  and  acrid, 
with  acrid  eructa- 
tions; lips,  and  lin- 
ing membrane  of  the 
mouth,  shrivelled  ; 
excruciating  pain  in 
the  stomach  ;  matter 
vomited  brown,  or 
black,  and  effervesces 
with  carbonate  of 
lime  ;  hiccough  ;  ten- 
derness of  the  ab- 
domen ;  laborious 
breathing  ;  extremi- 
ties cold  and  clam- 
my ;    great    sinking 


ANTIDOTES. 


Prompt  and  free 
use  of  mixtures  of 
chalk ;  th^  carbon- 
ate of  soda,  lime,  or 
magnesia,  with  milk. 
Any  of  these  may  be 
given  freely  for  citric 
acid,  or  for  muriatic 
and  sulphuric  acids  ; 
for  nitric  and  oxalic, 
the  carbonates  of 
magnesia  and  lime 
are  preferable. 


TESTS. 


oniric  acid  causea 
yellow  stains  ;  and 
sulphuric,  black. 
Citric  acid  Is  black- 
ened by  heat ;  Muri- 
atic acid  is  detected 
by  the  addition  of  ni- 
trate of  silver,  which 
throws  down  a  white 
precipitate,  an  inso- 
luble hydrochlorate 
of  silver.  The  nitrate 
of  baryta  in  solution 
gives  to  sulphuric 
acid  a  white  precipi- 
tate, insoluble  in  ni- 
tric acid.  Nitrio 
acid,  when  heated 
with  the  sulphate  of 


808 


204 


TOXICOLOGICAL    TABLE. 


NAMES. 


ACIDS- 

GorUinutd. 


ALKALIES. 

Potassa, 
Soda,  and  their 
carbonates. 


Mtrate  of  Pot- 
assa,  or  Salt- 
petre. 


AMKONIA  and 

iU  Salts. 


Sulphurei  of 
PotasHa,  or 
Liver  of  Sul- 
phur. 


ABSENIC  <md 
it*  cornbina- 
Uons. 


SYMPTOMS. 


and  exhaustion. — 
Burning  pains  in  the 
mouth,  throat  and 
stomach ;  vomiting 
of  darl£,  bloody  mat- 
ter, or  violent  purg- 
ing ;  pulse  faint  and 
fluttering  heart  be- 
comes paralyzed. 


Violent  burning ; 
caustic  taste  in  the 
mouth ;  deglutition 
difficult  and  painful, 
with  destruction  of 
the  lining  membrane 
of  the  mouth  and 
throat ;  vomiting  oft- 
en of  blood  ;  pain  in 
the  stomach ;  cold 
sweats ;  hiccough  ; 
bloody  stools  ;  sub- 
sultus  and  death. 

Severe  pains  in  the 
stomach,  and  over 
the  whole  body ;  vio- 
lent colic  pains,  with 
vomiting  and  purging 
of  bloody  matters. 


Symptoms  similar 
to  those  arising  from 
potassa  and  soda  ; 
pungent  suflTocating 
sensation ;  inflamma- 
tion of  the  mucous 
membrane. 


Tiolent  burning 
pain,  and  a  feeUng 
of  constriction  in  the 
throat ;  vomiting  ; 
strong  odor  of  hydro- 
sulphuric  acid  gas. 


Intense  heat  and 
pain  in  the  stomach  ; 
retching  and  vomit- 
ing ;  great  thirst ; 
sense  of  stricture  in 
the  throat ;  purging ; 
great  prostration  ; 
severe  spasms;  pallor 
of  the  face ;  clammy 
sweats ;  convulsions ; 
death. 


ANTIDOTES. 


Vineffar  or  lemon- 
juice;  the  fixed  oils, 
as  olive,  almond,  cas- 
tor, or  linseed  oils, 
convert  the  all^alies 
into  soap. 


Active  emetic ;  an- 
tiphlogistic treat- 
ment ;  plentiful 
draughts  of  mucilagi- 
nous drinlcs. 


Promptly  admin- 
ister vinegar,  or 
lemon-juice  ;  if  in- 
haled, inhale  heated 
vinegar. 


Chloride  of  soda  or 
lime ;  common  salt. 


Stomach-pump  ; 
emetics,  vomiting  ex- 
cited by  tickling  the 
throat  with  a  feather ; 
free  administration 
of  demulcents,  flax- 
seed tea,  warm  or 
cold  milk,  infusion  of 
slippery  elm.  But  the 
most  valuable  anti- 
dote is  the  freshly 
prepared  hydrated- 
peroride  of  iron, 
promptly       adminis- 


TESTS. 


indigo  in  a  tube,  de- 
stroys the  color.  OtB- 
alic  acid  gives  a 
dense  white  precipi- 
tate with  nitrate  of 
silver ;  and  with  lime- 
water  it  gives  a  white 
precipitate  which  is 
converted  into  chlo- 
rate of  lime  when 
heated. 

Caustic  potassa  hag 
a  soapy  feel,  is  very 
soluble,  the  solution 
having  a  strong  alka- 
line reaction ;  re- 
stores the  color  of 
turmeric  paper  that 
has  been  reddened 
by  an  acid. 


Yields  nitrous 
fumes,  when  heated 
with  strong  sulphuric 
acid ;  chloride  of  pla- 
tinum gives  a  yellow 
precipitate.  Nitrate 
of  Potassa  decrepi- 
tates on  hot  coals. 

Ammonia  is  dis- 
tinguished by  its 
pungent  odor.  Car- 
bonate of  Ammonia 
is  precipitated  by  the 
salts  of  lime.  Mu- 
riate  of  Am.monia, 
with  nitrate  of  silver, 
yields  an  ammonia- 
cal  odor. 

Liver  of  Sulphur, 
when  solid,  of  a  grey- 
ish, greenish,  or  yel- 
lowish color.  With 
mineral  acids,  gives 
off  hydrosulphuric 
acid  gas. 

Several  different 
tests  are  recommend- 
ed and  employed  for 
the  detection  of  this 
poison. 

Arsenic  in  the  solid 
form  should  be  re- 
duced to  the  metallic 
state,  by  mixing  it 
with  powdered  char- 
coal ;  then  introduce 
the  mixture  into  a 
small  glass  tube,  and 
heat  gradually  over 


TOXICOLOGICAL   TABLE. 


205 


NAMES. 


ARSENIC— 

Voi.tinueU. 


SYMPTOMS. 


ANTIDOTES. 


AirriMONT. 

Tdrtar  Emetic 


ALCOHOL. 


Violeot  Tomitings  ; 
great  heat  and  pain 
in  the  epigastric  re- 
gion;  purging;  colic 
paina ;  ditlicult  de- 
glutition ;  spasms. 


Wlien  taVen  to  ex- 
cess, intoxication  ; 
iiiseosibility ;      apo- 


tered  in  large  doses  ; 
or  the  precipitated 
carbonate  may  be 
administered  every 
five  or  ten  minutes. 


TVhen  vomiting  has 
not  talcen  place,  ad- 
minister large 
draughts  of  warm 
water ;  decoction  of 
hark,  or  of  ntit- 
gitlU  ;  opium,  when 
vomiting  has  con- 
tinued long  enough ; 
strong  decoction  of 
green,  tea. 

Stomach-pump ; 
powerful  emetic ;  co- 
pious   drauglitB    of 


TESTS. 


a  spirit-lamp;  a  dark, 
shining  metallic  crust 
will  be  formed,  a  por- 
tion of  which,  when 
heated,  will  give  out 
the  garlic  odor,  if 
arsenic  be  present. 

When  arsenic  ex- 
ists in  the  contents 
of  the  stomach,  in 
solution,  the  liquid 
must  be  first  clari- 
fied, and  to  this  clear 
solution  apply  the 
following  tests :  A 
stream  of  hydrosuU 
phurio  acid  go* 
throws  down  a 
bright  yellow  pre- 
cipitate. Ammo- 
niaco-nitrate  of  sil- 
ver causes  a  yellow 
precipitate,  which 
soon  changes  to  a 
brown.  Ammonia- 
co-milphat«  of  cop- 
per gives  a  green 
precipitate.  The 
metallic  crust  will  be 
obtained  by  heating 
any  of  these  precipi- 
tates with  powdered 
charcoal  in  a  glass 
ttrbe. 

Marsh's  test  con- 
sists "  in  throwing 
some  of  the  suspect- 
ed fluid  into  a  mix- 
ture of  one  part  of 
sulphuric  acid  and 
six  of  water,  and 
some  pure  line  being 
added,  in  setting  fire 
to  the  gas,  as  it  issues 
from  the  jet,  and 
holding  over  it  a 
plate  of  glass;  if  there 
be  any  arsenious  acid 
present  in  the  fluid, 
a  spot  of  metallic 
arsenic  will  be  ob- 
tained." 

Infusion  of  gall- 
nuts  gives  a  dirty 
v:hite  precipitate ; 
subcarbonate  of  pot- 
assa,  a  white  precipi- 
tate. 


206 


TOXICOLOGICAL    TABLE. 


NAMES. 


ALCOHOL— 
Continued. 


BAB7TA. 


BISMTTTH. 


CANTHABIDES 


COFFEB. 


HYDROCYA 
NIC   ACID. 

Prussie  Acid. 


IODINE. 


SYMPTOMS. 


plexy ;  paralysis  ; 
face  EWoUea  ;  diffi- 
cult, stertorous 
breathing ;  breath 
has  the  odor  of  alco- 
hol. 


Symptoms  analo- 
gous to  those  of 
Irritant  poisons  in 
general  ;  respiration 
weali ;  great  prostra- 
tion ;  convulsions  ; 
death. 


Very  similar  in  its 
action  to  that  of 
other  irritant  poi- 
sons; acrid  disagree- 
able taste  ;  great  ir- 
ritation of  the  lining  !  pies, 
membrane     of     the 

canal ; 
spasms  ; 

urine ; 


warm  water,  to  en- 
courage vomiting  ; 
large  injections  of 
salt  and  water  ;  erect 
position  ;  friction  to 
the  extremities  when 
cold. 


The  sulphates  of 
soda  or  magnesia  are 
prompt  antidotes. 


Administer  muci- 
laginous drinl{s  free- 
ly ;  milk  ;  reduce 
inflammatory  action, 
on    general     princi- 


alimentary 
vomiting  ; 
suppressed 
death. 


Excessive  irritation 
and  burning  in  the 
throat,  stomach,  and 
belly  ;  aversion  to 
liquids ;  frequent, 
sometimes  bloody, 
vomiting ;  priapism ; 
strangury,  with  heat 
in  the  bladder  ;  blood 
from  the  urethra  ; 
delirium  ;  convul- 
sions ;  death. 

Symptoms  resem- 
ble those  caused  by 
arsenic,  and  corro- 
sive sublimate;  a  pe- 
culiar coppery  taste 
in  the  mouth ;  cop- 
pery eructations ;  if 
fatal,  death  preceded 
by  convulsions  and 
insensibility. 

Small  doses  cause 
nausea,  pain  in  the 
head,  salivation.  In 
large,  fatal  doses, 
death  almost  instan- 
taneous ;  death  is 
sometimes  preceded 
by  convulsions. 

Burning  pain  in  the 
throat  and  pit  of  the 
stomach  ;  retching  ; 
great  pain  and  ten- 
derness of  the  epi- 
gastrium ;  eyes  suf- 
fused; headache. 


Emetics  ;  encour- 
aged by  copious 
draughts  of  tepid 
water;  milk,  linseed 
tea,  sugar  and  water 
very  freely  ;  oily  and 
demulcent  injections 
into  the  bladder  to 
ease  the  strangury  ; 
antiphlogistic  treat- 
ment. 


The  whites  of  eggs  ; 
albumen  in  any 
fo  m  ;  milk  ;  iron 
filings  are  useful. 


Ammonia,  in  a 
concentrated  form, 
should  be  adminis- 
tered ;  the  inhalation 
of  ammoniacal  wa- 
ter ;  chlorine ;  cold 
affusion  to  the  head. 


Vomiting  encour- 
aged by  tepid  water ; 
administer  starch ; 
wheat  flour  mixed 
with  water. 


TESTS. 


Sulpiiuric  acid,  or 
the  sulphates. 


Am-monia  gives  to 
a  solution  of  copper 
a  beautiful  blue  co- 
lor. A  polished  iron 
bar  dipped  in  a  solu- 
tion of  copper  18 
coated  by  a  crust  of 
the  metal. 


The  peculiar  or 
peach-kernel  odor  ; 
nitrate  of  silver 
causes  a  white  pre- 
cipitate; persalts  of 
iron  yields  a  greyish 
green  precipitate. 


Peculiar  odor ; 
mixed  with  a  solution 
of    starch,  yields    a 
blue  precipitate. 


TOXICOLOGICAL    TABLE. 


207 


NAMES. 


LEAD. 

Litharge. 
Bed  Lead. 
White  Lead. 
Carbonate  of 

Lead, 
Sugar  of  Lead. 


UEBCTJBY. 

Corrosive  Subli- 
mate. 

Nitrate  of  Mer- 
cury. 

Cyanide  of  Mer- 
cury, 


NAKCOTIC 

POISONS. 

Opium, 
Henbane, 
Lettuce  Opium, 
Solanum, 
Laurel,  etc. 

DIAGNOSIS  OF 

APOPLEXY 

and 

NAECOnC  POI 

£OyS. 


OPIUM. 


SYMPTOMS. 


Sometimes  slight 
irritation  only  is  pre- 
sent ;  usually  symp- 
toms of  Inflammation 
occur,  combined  with 
those  of  lead-colic, 
followed  by  convul- 
sions, coma,  or  by  lo- 
cal paralysis ;  death. 


Excessive  styptic 
taste  -,  burning  in  the 
throat ;  violent  vo- 
miting; purging  of 
blood  ;  great  irrita- 
tion of  the  urinary 
organs ;  loss  of  voice ; 
cold,  clammy  sweats ; 
tendency  to  stupor ; 
coDTUlsiODS ;  death. 


"  1.  Apoplexy  is 
generally  preceded 
by  certain  premoni- 
tory symptoms, head- 
ache, tinnitus  auri- 
ura,  etc.  2.  Apoplexy 
generally  attacks  old 
plethoiic  persons.  8. 
The  symptoms  of  nar- 
cotic poisons  come  on 
gradually ;  those  of 
apople.xy  generally 
set  in  suddenly.  4. 
In  apoplectic  stupor, 
the  patient  cannot  be 
aroused  to  conscious- 
ness ;  whilst  in  nar- 
cotism, the  patient 
may  be  aroused  from 
the  deepest  lethargy 
by  shaking,  by  inject- 
ing water  into  his 
ear,  or  by  speaking 
to  him  in  a  loud 
voice." 

Giddiness  ;  heavi- 
ness in  the  head  ; 
stupor,  not  preceded 
by  any  excitement ; 
inclination  to  vomit ; 
slow  breathing;  pu- 


ANTIDOTES. 


Emetic  of  sulphate 
of  zinc  ;  Epsom  or 
Glauber  salts ;  chlor- 
ate of  potash  ;  dilute 
sulphuric  acid.  In 
paralysis,  strychnia ; 
in  the  mild  form, 
iodide  of  potait- 
»ium. 


Whites  of  eggs  ; 
milk ;  gluten  of 
wheat ;  albumen  in 
any  form  should  be 
promptly  adminis- 
tered. 


Evacuate  the  sto- 
mach. Emetics  of 
sulphate  of  zinc,  as- 
sisted by  titillationof 
the  throat ;  cold  wa- 
ter   dashed    on    the 


TESTa 


Iodide  of  potas- 
sium and  chromate 
of  potassa,  yield  a 
fine  yellow  precipi- 
tate. A  slip  of  zinc 
held  in  the  solution 
receives  a  deposit  of 
the  lead,  in  the  form 
of  arborescent  crys- 
tab. 

"  Obtain  a  solution 
of  corrosive  subli- 
mate, of  which  place 
a  drop  on  the  surface 
of  polished  gold,  then 
bring  a  bit  of  iron  in 
contact  with  both — a 
galvanic  circle  is  thus 
formed,  and  the  acid 
will  be  transferred  to 
the  iron,  whilst  the 
metallic  mercury  will 
be  deposited  on  the 
gold." 

Potassa  yields,  with 
a  solution  of  corro- 
sive sublimate,  a  yel- 
lowish precipitate ; 
ammonia,  a  white  ; 
lime  water,  an  or- 
ange ;  and  sulphur- 
eted  hydrogen,  a 
black  precipitate. 


208 


TOXICOLOGICAL   TABLE. 


NAMES. 


OPWM- 

Qmtinued 


HYOCYAMTJS, 

or 
HENBANE. 

NARCOTIC 

ACBID 

POISONS. 


ATBOPA 

BELLADONNA. 

Cicttta    Macu- 

lata, 
Hemlock, 
Tobacco, 
Thorn-apple, 

HtlVtbort^ 
Ergot,  etc  eto. 


SYMPTOMS. 


pils  generally  con- 
tracted ;  eyes  closed ; 
ghastly  features  ;  in- 
clination to  sleep  ir- 
resistible ;  sometimes 
furious  delirium  ; 
pulse  very  feeble ; 
limbs  relaxed ;  death. 


Vertigo ;  pupils  di- 
lated ;  loss  of  voice  ; 
coma,  or  violent  de- 
lirium. 

This  class  of  poi- 
sons includes  those 
possessing  a  double 
action,  the  one  local 
and  irritating,  the 
other  consisting  of  an 
impression    on     the 

nervous  system, 
which  is  sometimes 
indicated  by  narco- 
tic, and  at  other 
times  by  violent  teta- 
nic, symptoms.  They 
generally  prove  fatal 
by  their  action  on 
the  nervous  system. 
The  organs  on  which 
they  act  remotely  are 
the  brain,  the  spinal 
cord,  and  sometimes 
the  heart. 

Convulsive  actions 
of  the  muscles  of  the 
face  and  limbs  ;  vio- 
lent agitation ;  deli- 
rium ;  severe  vomit- 
ing and  purging ; 
great  prostration ; 
couvuIsioDs ;  death. 


ANTIDOTES. 


face,  where  the  sto- 
mach is  torpid,  may 
assist  the  action  of 
the  emetic.  Large 
salt  water  or  soap 
and  water  injections, 
to  evacuate  the  bow- 
els. The  utmost  pains 
should  be  taken  to 
keep  the  patient 
aroused  by  causing 
incessant  action.  He 
should  be  dragged 
between  two  assist- 
ants, and  cold  water 
be  repeatedly  dashed 
on  his  head.  Artifi- 
cial respiration,  stim- 
ulants, as  ammonia, 
camphor,  etc. 

After  the  poison  is 
removed,  strong  cof- 
fee, decoction  of 
galls,  vegetable  acids 
may  be  administer- 
ed. If  the  heat  de- 
clines, frictions  and 
warmth  must  be  per- 
severingly  employed. 

Same  antidotes  as 
in  treatment  for 
opium. 


TESTS. 


Active  emetic  •,  ftee 
purging  with  saline 
cathartic.  If  stupor, 
venesection  is  recom- 
mended. Leeches, 
etc.,  if  inflammatory 
symptoms  arise. 


TOXICOLOGICAL    TABLE. 


209 


NAMES. 


STRYCHNIA. 

Niix  Vomica, 
Cocculu*  Indi- 

cus. 
Upas, 
Woorara. 


TIN. 

Bichloride, 
Oxide. 


ZINC. 

Sulphate, 
Acetate, 


SYMPTOMS. 


These  poisons  act 
on  the  spinal  cord,  in- 
ducing convulsions, 
stillness,  and  spasms 
of  the  muscles  of 
respiration.  Death 
may  suddenly  result 
from  spasms,  or  the 
patient  may  die  ap- 
parently from  ex- 
haustion, or  from  in- 
flammation of  the 
stomach  and  bowels. 

Severe  colic  pains ; 
violent  purging.  In 
fatal  cases,  somno- 
lency and  catalepsy. 


Metallic  taste ;  vio- 
lent vomiting  and 
purging  ;  sense  of 
constriction  in  the 
throat ;  pains  in  the 
epigastrium ;  dysp- 
noea ;  great  paleness. 


ANTIDOTES. 


Immediate  expul- 
sion of  the  poison 
from  the  stomach,  by 
the  stomach-pump  or 
by  an  active  emetic. 
Iodine,  chlorine,  and 
bromine,  are  said  to 
be  antidotes  to  the 
aliialoids. 


Millc  administered 
freely  ;  bicarbonate 
of  soda ;  decoction 
of  nut-galls. 


Carbonate  of  soda 
in  solution ;  millc 


TESTS. 


When  strong  the 
bichloride  of  tia 
coagulates  milk  com- 
pletely ;  precipitates 
vegetable  coloring 
matter. 

Hydrosulphuric 
acid  throws  down  a 
wliite  precipitate. 
The  free  all^alies 
give  a  white  precipi- 
tate. 


Id 


INDEX 


PAGE 

A. 

Acetate  of  Lead  with  Digitalis, 

etc 132 

Acid,  Hydrocyanic      ....     17 
"             "           medicinal .     .     23 
"             "           in  Bronchitis     18 
Acid,  Hydrocyanic,  in  Broncho- 
Gastritis     22 

Acid,  Hydrocyanic,  in  Gastralgia     22 
"  "  in    Hooping 

Cough      .     19 
"             "              in   Tubercu- 
losis    .     .18 
Aconite  with  Arsenic  ....     58 
Adulterations  of  Iodide  of  Po- 
tassium   67 

Albuminuria,  Remedy  in  .     .     .  137 
Aloes,  Guiac  and  Gamboge  Pills     99 

"      Calomel,  etc 100 

"      Carb.  of  Soda,  etc.     .     .  104 

>'      Uhubarb,  etc 101 

"      Sulph.  of  Iron,  etc.    .     .110 

"      Taraxicum,  etc.     .     .     .   106 

American  Hellebore     ....     90 

Aiiienorrhoea,  Treatment  of       .171 

A.-niaonia  Garb.,  with  Caniph., 

etc 146 

Auiinoniacal   Mixtures,  Squills, 

etc 121 

Antacids  and  Antilithics.      .     .183 

Anthelmintics 160 

Antimony  with  lod.  of  Potas- 
sium        67 

Antimony  with  Ipecacuanha     .  114 

Antispasmodics 153 

Arsenic,  its    Physiological  and 

Therapeutical  Effects    ...     41 

Arsenite  of  Potash  with  Iodine     7-3 

Arthritic  Diathesis,Treatment  of  188 

Assafcetida  w^Sh  Morphia,  etc.  .  154 

"  >•     Musk,  etc.  .     .154 

Astringents 129 

"Ayer's  Cherry  Pectoral'-  .     86 

B. 
Barker,  Prof,  in  Menorrhagia  .  138 

Balsam  of  Canada 1 24 

"                "      with  Cyanide 
of  Potass.        125 


FAGl 

Balsam  of  Copaiba  with  Tiact. 

Opium 125 

Begbie,  Dr.,  on  Arsenic  ...  41 
Belladonna  with  Quinine  .  .  58 
Bi-Carbonate  of  Potash  .  .  .  145 
Bi-Chlo.  of  Mercury,  excellent 

Alterative 75 

Bi-Carb.  Potash,  Hydrocy.  Acid, 

etc 59 

Biniodide  of  Mercury  .  .  .168 
Blue  Mass,  Rhei,  Aloes,  etc.      .  lo3 

Bloodroot 84 

"  as  an  Emetic  .  .  .118 
Bowditch,  Dr.,  on  Fusel  Oil .  .  49 
Bronchitis,  Remedy  for    .     .     .   135 

C. 

Calomel  with  Sugar      ....     78 
"  "     Opium  and  Ipecac     79 

Camphor   Mixture  with   Ether, 

etc 149 

Canada  Balsam 124 

Cancerous  Affections,  Treatment 

of 74 

Capsicum,  Tincture  of,  etc.  .     .138 
Carbonate  Ammonia,  etc.     .     .   146 
Carbonate  of  Mang.  in  Mesen- 
teric Disease 148 

Carminative     Mixture    of    Dr. 

Dewees ISO 

Carnochan,  Prof,  on  Donovan's 

Sol 66 

Castor  in  Hysteria 155 

Castor  with  Sulph.  Morphine  .  156 
Cathartics  and  Laxatives  .  .  96 
Ciiapmaii's,  Dr.,  Antidvspeptic 

Pills '  .     .     . 

Chenopodium  an  Anthelmintic  li)7 
Cholera,  Remedy  for  .  .  .  .138 
Chorea,  Cimicifuga  in  ...  89 
Chronic  Diarrhoea,  Remedy  in  .  185 
Cimicifuga  Racemosa  ....  88 
Cinchona  Comp.,  Tinct.,  etc.     .  151 

Citrate  of  Iron 37 

Clark,  Dr.,  on  EflTects  of  Iodine  Gd 
Colchicum,  Tiuct.,  with  Infus.  of 

Juniper 15<i 

Colchicum  Wine  with  Digitiilis  l:.ii 


212 


INDEX 


PAOK 

CoUjrium 202 

Coniiim  and  Iron  as  a  Tonic  .  36 
Corrosive   Sublimate  with    Co- 

niuin 75 

Corrosire  Sublimate  with  Opium  76 

Cox,  Dr.  A.  L.,  Anthelmintic    ,  163 

Cox,  Dr.  C.  C,  Cathartic  Pill    .  102 

"  "  "  Formula  from  .  28 
Creosote,  Tinct.  of  Myrrh,  etc., 

Gargle 178 

Cyanide  of  Potassium     ...  24 

D. 

Davis,  Prof.  E.  H.,  Carminative  187 
Davis,  Prof.  N.  S.,  Pills  for  Con- 
stipation  .  110 
"  "        "     Remedy     in 

Dysmenorrhoea 175 

Decoction  of  Senega,  etc.  .  .  120 
Dewees  Dr.,  Emmenagogue  .  176 
Derivatives,  Ointments,  etc.      .   190 

Diaphoretics 140 

"          in  Disease  of  Respi- 
ratory Organs 144 

Dickson,  Prof.  S.  H.,  Cathartic 

Mixture 107 

Dickson,    Prof.    S.    H.,    Cough 

Mixture 122 

Discoloration   from   Nitrate    of 

Silver 30 

Diuretics 147 

Donovan's  Solution     ....     66 

Dover's  Powder,  etc 143 

Dropsy,  Remedy  for  ....  28 
Dupasquier,  Dr.,  on  Proto-Iod. 

of  Iron 70 

"  Dyuamization"  of    Medicines 

untenable 78 

Dysentery,  Remedy  in      .     .     .   133 
Dzondi,  Dr.,  on  Bi-Chloride  of 
Mercury 76 

E. 
Elaterium  a  Diuretic    .     .     .     .151 
Emetics  and  Expectorants    .     .  112 
Emetics,  their  Manner  of  Oper- 
ating      112 

Emmenagogues 170 

Excitants  and  Alteratives     .     .     60 
Extract  of  Belladonna  and  Hy- 
drocyanic Acid 22 

Extract  of  Belladonna  in  Dys- 
menorrhoea      27 

Extract  of  Belladonna  and  Qui- 
nine in  Gastralgia     ....     28 
Extract  of  Hyosciamus  in  Neu- 
ralgia      25 


Extract  of  Hyosciamus  and  Ni- 
trate of  Silver  in  Leucorrhcpa     27 

Extract  of  Hyosciamus  and  Bis- 
muth in  Gastralgia  ....     29 

Extract  of  Hyosciamus  and  Va- 
lerianate of  Iron      ....     25 

Extract  of  Lupulin  and  Nitrate 
of  Silver  in  Gastritis     ...     31 

F. 

Ferro-Manganese  in  Ulcorated 
Sore  Mouth 48 

Fowler's  Solution  in  Intermit- 
tent   40 

Frisch,  Dr.,  on  Nux  Vomica      .     54 

Fuller,  Dr.,  Treatment  of  Rheu- 
matism   188 

Fusel  Oil,  a  substitute  for  Cod- 
liver  Oil 49 

G. 
GaUic  Acid 137 

"  "  in  Menorrhagia  .  .  137 
Gargles  and  Lotions  ....  177 
Gastralgia,  Treatment  of      .     .     28 

Gastrodynia 18-1 

Glycerine  with  Syrup  of  Iron    .  127 
Glycerine  with  Hypophosphate 

of  Soda      .     .  ■ 127 

H. 

Heartburn,  Remedy  for   .     .     .185 

Hiccough  treated  by  Musk   .     .  155 

Hydrargyrum  cum  Creta       .     .  77 

Hydrargyro-Iodide  of  Potass.    .  63 
Hyosciamus,    Blue    Mass,    and 

Ipecacuanha 109 


Infusion  of  Digitalis,  Tinct.  of 

Cantliarides,  etc 149 

Injections  for  Worms  ....  168 
Intermittents,  Treatiiiont  of  .  40 
Iodide  of  Arsenic,  an  Excitant 

and  Tonic  ...  72 
"  "  Iron,  a  Tonic  ...  72 
"        "       "    etc  ,  in  Uterine 

Diseases  ....     38 
*'        "    Lead,  a  Diuretic       .     72 
*'        "    Manganese,  an  Excit- 
ant and  Alterative     74 
**        "   Manganese  in  Blood 

Diseases ....  46 
"        "   Mercury,  an  Altera- 

ative 72 

"        ♦'   Potassium,  Adulter- 
ations of      ...     71 


INDEX 


213 


PAGE 

Iodide  of  Potass,  with  Senega  63 
it        u         .1          4.      Hydro- 
cyanic Acid  67 
"        "         "        iu   Follicular 

Disease      .  61 
"        "     Sulphur  acts  on  the 

skin 12 

Iodine  with  Iodide  of  Potass.   .  62 

"      in  Scrofula 68 

"     with  Liquor  Potassa  .     .  68 

"        "     Iron 69 

J. 

Juniper,  Infusion  of,  with  Ether, 

etc 148 

"       Berries,  with  Nitrate  of 

Potash,  etc 152 

Kidneys,  Haemorrhages  from     .  136 
Kousso  an  Anthelmintic  .     .     .164 
Kuchenmeister  on  animal  and 
vcc-etable  Parasites .     .     .     .160 


Lavender  with  Tinct.  of  Opium, 

etc 157 

Laxatives 96 

Lindsly,  Prof.,  on  Treatment  of 

Neuralgia 58 

Lindsly,  Prof.,  on  Treatment  of 

Constipation Ill 

Liniment  of  Arnica,  etc.  .     .     .  193 
"  Dr.  Lindsly  .     .     .194 

Liniment  for   Inflammation   of 

the  Lungs 195 

Liniment  for  Sore  Throat     .     .  193 
Lithic    Acid    Diathesis,    Treat- 
ment of 187 

Lobelia  in  Spasmodic  Asthma  .  56 
"  as  an  Emetic  .  .  .  .118 
"  and  Squills  .  .  .  .119 
Lotion  for  old  Ulcers  .  .  .  .182 
"  "  Neuralgia  .  .  .  .192 
"      in  Ophthalmia  ....  202 

M. 

Magnesia,  Rhei,  etc..  Mixture    .  107 


it 

Sulphate,  with  El 

xir 

of  Vitriol 

.  128 

Male  Fern 

an  Anthelmintic 

.  169 

Manganese  in  the  Blood  . 

.     4.3 

Carbonate  of. 

.     47 

Iodide  of  .     . 

.     46 

Malate  of  .     . 

.     45 

Phosphate  of 

.     44 

in  Tuberculo.sis 

.     44 

Morphine 

Acetate,  with  Cyanide  " 

of  Potass.,  etc.    .     .     . 

.   120 

PA08 

Muriate  of  Ammonia  in  Phthisis     33 
Musk  with  Sulph.  Ether,  etc.     .  155 

N. 
Narcotics  and  Sedatives  ...     17 
Nitrate  of  Potash  with  Antimony  145 
"  "  "    Opium      .  143 

Nitrate  of  Silver  Gargle  .     .     .177 
Norwood,  Dr.  W.  C,  on  Vera- 

trum  Viride 91 

Nux  Vomica  in  Gastric  Affec- 
tions       51 

Nux  Vomica  in  Paralysis      .     .     56 

0. 

Oak  Bark  as  a  Gargle  .     .     .     .181 
Oil,  Castor,  with  Nitrate  of  Pot- 
ash, etc 108 

Oil  of  Chenopodium    .     .     .     .167 
Oil  of  Turpentine  an  Anthelmin- 
tic      165 

Ointment  for  Counter-Irritation  195 

"         "    Eczema  ....  201 

"         "   Hemorrhoids   .     .  198 

"         "    Neuralgia    .     .     .  200 

"         "   Ophthalmia      .     .  201 

"         in  Tuberculosis     .     .197 

"         for  Indurated  Os  .     .     38 

"         of  Iodide  of  Lead     .     73 

Olive  Oil  in  Ascarides      .     .     .167 

Opium  with  Lead,  etc.      .     .     .  131 

"     Nitrate  of  Silver     .  131 

"     Officinal  Mass  of  .     .     .  130 

P. 

Painful  Menstruation,  Remedy  ia  174 

Peaslee,  Prof.,  Remedy  for  Con- 
stipation      105 

Phosphate  of  Manganese  in  Tu- 
berculosis   44 

Phosphate  of  Iron  and  Quinine 
in  Chlorosis 37 

Pierquin,  Dr.,  on  Iodine  and  Iron    69 

Piperine  and  Quinine  an  Anti- 
periodic     65 

Pink  Root  an  Anthelmintic  .     .163 
"       "     w  ith  Tin     ...     .  162 

Podophyllium,  Extract  of    .     .     81 

Porcher,  Dr.,  Prescription  from     32 
"  "     Cathartic  Mixture  107 

Potassium,  Iodide  of,  iu  Follicu- 
lar Disease 61 

Protioilide     of    Mercury    with 
Iodide  of  Potassium     ...     64 

Pulse  reduced  by  Veratrum  Vi- 
ride   92 


214 


INDEX 


PAOB 

Purgatives 96 

Q. 

Quinine  and  Arsenic  in  Inter- 
mittent   40 

Quinine  and  Morphine  in  Riieu- 
matism 32 

R. 

Raimann,  Prof.,  on  Kousso  .     .165 
Refrigerant  in  Fevers  ....  141 
Rheumatism,  Ciraicifuga  in  .     .     89 
"           Remedy  for     .     .  143 
Rheumatic  Liniment   .     .     .     .191 
Roe,  Dr,  Hamilton,  on  Hydro- 
cyanic Acid  and  on  Hooping- 
Cough 19 

S. 

Sanguinaria 84 

"  as  an  Emetic     .     .118 

"  with  Aloes    ...     85 

"  with  Ipecacuanha  .     86 

"  "  "         and 

Opium 86 

Sanguinaria,  with  Digitalis  and 

Opium 87 

Santonine  an  Anthelmintic  .     .  166 

Senega  with  Iodide  of  Potassium     62 

"         "    Tolu,  etc.      .     .     .  123 

"         "    Squills      ....  124 

Senna,  Rhubarb,  etc 108 

Serpentaria,  Ipecacuanha,  etc.  .  144 
Solution  of  Strychnia       ...     53 
"  "  and  Qui- 

nine in  Intermittent  ...  54 
Spasmodic  Asthma,  Remedy  in  119 
Spirits  of  Mindereri,  Antimonial 

Wine,  etc 140 

Squills,  Tolu,  Bloodroot,  etc.     .  122 
Stokes,  Dr.,  Mixture  in  Bron- 
chitis      121 

Strammonium  in  Nervous  Dis- 
eases      3 

Strychnine    as    a    Therapeutic 

Agent 50 

Strychnine  in  Impotence      .     .     55 

Styptics 129 

Sudorifics 140 

Sulphate  of  Copper  an  Emetic  .  117 
Sulphate  of  Iron  and  Potassa  in 

glandular  enlargements  .  .  39 
Sunderlin,  Dr.,    on  Muriate  of 

Ammonia 32 

Syrup  of  Iodide  of  Iron  ...     70 
"  "  Manganese.     74 


PAOB 

T. 
Tannic  Acid 136 

"  "  with  Opium .  .  .136 
Taraxicum  and  Iron  as  a  Tonic  37 
Test  for  the  Purity  of  Iodide  of 

Potassium 71 

Tincture  of  CimicifugaRacemosa     88 
"  Catechu,  etc.  .     .     .133 

"  Veratrum  Viride      .     94 

Tobacco  Ointment 201 

Tonics  and  Stimulants      ...     34 
"                  "       Their  differ- 
ence        34 

Trousseau  and  Pidoux     .     .     .  168 
TuUy,  Prof,  on  Veratrum  Viride     91 
Turpentine,  Tinct.  Opium,  etc.  .  134 
"  as  an  Anthelmintic  165 

Turpeth  Mineral  Emetic  .     .     .116 
Typhoid  Fever,  Remedy  in  .     .134 

U. 

Uterine  Hiemorrhage,  Remedy 
for 136 

Uva  Ursi  with  Tannic  Acid  .     .  137 

V. 

Vaginal  Injection 181 

Valerian  with  Garb.  Magnesia, 

etc 156 

Valerianate  of  Iron  in  Chorea  .     25 
"           "  Ammonia      .     .169 
"           "         "       in  Neu- 
ralgia     25 

Valerianate    of  Zinc   in  Facial 

Neuralgia 26 

Valerianate  of  Zinc  in  Hysteria  157 

"         "     "    with  Bismuth  158 

Veratrum  Ointment     ....  200 

Veratrum  Viride 90 

W. 

Ware,  Dr.  John,  Pills  in  Con- 
stipation      Ill 

Ware,  Dr.  John,  Remedy  for 
Chlorosis 172 

Ware,  Dr.  John,  Remedy  for 
Diarrhoea 135 

Winston,  Prof.,  on  Veratrum 
Viride 91 

Wormseed,  Oil  of 167 

Wyman,  Dr.,  on  Fusel  Oil    .     .     49 

Z. 

Zinc  with  Ipecacuanha     .     .     .116 
"      "     Opium 135 


14  DAY  USE 

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